{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:16:39Z","timestamp":1793718999594,"version":"4.6.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:00:00Z","timestamp":1640217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K24AI121296"],"award-info":[{"award-number":["K24AI121296"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI134637"],"award-info":[{"award-number":["R01AI134637"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI48342,"],"award-info":[{"award-number":["R01AI48342,"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["P01AI152999"],"award-info":[{"award-number":["P01AI152999"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI104681"],"award-info":[{"award-number":["UM1AI104681"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Millennium Science Initiative","award":["MICROB-R, NCN17_081"],"award-info":[{"award-number":["MICROB-R, NCN17_081"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5T32AI055449-15"],"award-info":[{"award-number":["5T32AI055449-15"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01AI148593"],"award-info":[{"award-number":["K01AI148593"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32GM086330"],"award-info":[{"award-number":["T32GM086330"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI134637"],"award-info":[{"award-number":["R01AI134637"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Vancomycin-Resistant Enterococcal BSI Outcomes Study (VENOUS I) is a prospective observational cohort of adult patients with enterococcal BSI in 11 US hospitals. We included patients with Enterococcus faecalis or Enterococcus faecium BSI with \u22651 follow-up blood culture(s) within 7 days and availability of isolate(s) for further characterization. The primary study outcome was in-hospital mortality. Secondary outcomes were mortality at days 4, 7, 10, 12, and 15 after index blood culture. A desirability of outcome ranking was constructed to assess the association of vancomycin resistance with outcomes. All index isolates were subjected to whole genome sequencing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-two of 232 (18%) patients died in hospital and 39 (17%) exhibited microbiological failure (lack of clearance in the first 4 days). Neutropenia (hazard ratio [HR], 3.13), microbiological failure (HR, 2.4), VRE BSI (HR, 2.13), use of urinary catheter (HR, 1.85), and Pitt BSI score \u22652 (HR, 1.83) were significant predictors of in-hospital mortality. Microbiological failure was the strongest predictor of in-hospital mortality in patients with E faecium bacteremia (HR, 5.03). The impact of vancomycin resistance on mortality in our cohort changed throughout the course of hospitalization. Enterococcus faecalis sequence type 6 was a predominant multidrug-resistant lineage, whereas a heterogeneous genomic population of E faecium was identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab616","type":"journal-article","created":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T06:13:25Z","timestamp":1640326405000},"source":"Crossref","is-referenced-by-count":51,"title":["Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I)"],"prefix":"10.1093","volume":"9","author":[{"given":"German A","family":"Contreras","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M","family":"Munita","sequence":"additional","affiliation":[{"name":"Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"Genomics and Resistant Microbes Group, Facultad de Medicina Cl\u00ednica Alemana, Universidad del Desarrollo, Santiago, Chile"},{"name":"Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Simar","sequence":"additional","affiliation":[{"name":"Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Luterbach","sequence":"additional","affiliation":[{"name":"Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An Q","family":"Dinh","sequence":"additional","affiliation":[{"name":"Center for Infectious Diseases Research, Houston Methodist Research Institute, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Rydell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Houston Methodist Hospital, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranoti V","family":"Sahasrabhojane","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Rios","sequence":"additional","affiliation":[{"name":"Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Diaz","sequence":"additional","affiliation":[{"name":"Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7328-4898","authenticated-orcid":false,"given":"Marcus","family":"Zervos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helina M","family":"Misikir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Sanchez-Petitto","sequence":"additional","affiliation":[{"name":"Department 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M","family":"Abbo","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA"},{"name":"Jackson Health System, Miami Transplant Institute, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Shimose","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Seifert","sequence":"additional","affiliation":[{"name":"University of Cologne, Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlota","family":"Gudiol","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, l\u2019Hospitalet de Llobregat, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salut Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Barberis","sequence":"additional","affiliation":[{"name":"Unidad de Infectolog\u00eda, Sanatorio Dr Julio M\u00e9ndez, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pedroza","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel L","family":"Aitken","sequence":"additional","affiliation":[{"name":"Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A","family":"Shelburne","sequence":"additional","affiliation":[{"name":"Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA"},{"name":"University of Texas MD Anderson Cancer Center, Houston, Texas, USA"},{"name":"Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-3227","authenticated-orcid":false,"given":"David","family":"van Duin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truc 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