{"doi":"10.1093/ofid/ofab616","title":"Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I)","abstract":"Abstract Background Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking. Methods 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 ≥1 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. Results 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 ≥2 (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. Conclusions Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes.","journal":"Open Forum Infectious Diseases","year":2021,"id":162528,"datarank":1.7876744736723613,"base_score":3.8712010109078907,"endowment":3.8712010109078907,"self_citation_contribution":0.5806801516361837,"citation_network_contribution":1.2069943220361776,"self_endowment_contribution":0.5806801516361837,"citer_contribution":1.2069943220361776,"corpus_percentile":88.18751450452541,"corpus_rank":1528,"citation_count":47,"citer_count":29,"citers_with_citation_signal":24,"citers_with_endowment":24,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7398,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":343888,"name":"José M. Munita","orcid":"0000-0002-7870-1056","position":1,"is_corresponding":false},{"id":679916,"name":"Shelby R. Simar","orcid":"0000-0002-7221-0248","position":2,"is_corresponding":false},{"id":232754,"name":"Courtney Luterbach","orcid":"0000-0003-2509-0842","position":3,"is_corresponding":false},{"id":232752,"name":"An Q Dinh","orcid":"0000-0002-2965-9269","position":4,"is_corresponding":false},{"id":680936,"name":"Kirsten Rydell","orcid":null,"position":5,"is_corresponding":false},{"id":484064,"name":"Pranoti Sahasrabhojane","orcid":null,"position":6,"is_corresponding":false},{"id":343882,"name":"Rafael Ríos","orcid":"0000-0002-1556-9369","position":7,"is_corresponding":false},{"id":343890,"name":"Lorena Díaz","orcid":"0000-0002-9783-1956","position":8,"is_corresponding":false},{"id":680937,"name":"Katherine Reyes","orcid":null,"position":9,"is_corresponding":false},{"id":486262,"name":"Marcus Zervos","orcid":"0000-0002-7328-4898","position":10,"is_corresponding":false},{"id":680938,"name":"Helina Misikir","orcid":null,"position":11,"is_corresponding":false},{"id":679917,"name":"Gabriela Sanchez‐Petitto","orcid":"0000-0002-1000-1643","position":12,"is_corresponding":false},{"id":348340,"name":"Catherine Liu","orcid":"0000-0002-7532-4822","position":13,"is_corresponding":false},{"id":232746,"name":"Yohei Doi","orcid":"0000-0002-9620-2525","position":14,"is_corresponding":false},{"id":226690,"name":"Lilian M. 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Tran","orcid":"0000-0002-2696-4196","position":24,"is_corresponding":false},{"id":232743,"name":"Blake Hanson","orcid":"0000-0003-2949-7818","position":25,"is_corresponding":false},{"id":232742,"name":"César A. Arias","orcid":"0000-0001-9054-9774","position":26,"is_corresponding":false},{"id":680935,"name":"German Contreras","orcid":null,"position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-18T23:45:05.641178Z","pmid":"35155713","pmcid":"PMC8830530","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}