Despite the development of increasingly active antibiotics, there has been no significant improvement in treatment outcomes for patients with bacteremia caused by vancomycin-resistant enterococci (Vancomycin-resistant Enterococcus - ERV). In addition, the effect of antibiotic resistance on clinical outcomes in these patients remains unclear. To date, there are a limited number of studies that compare patient outcomes in an earlier era of enterococcal resistance to vancomycin compared to today, when more potent antimicrobial agents have appeared in the arsenal of doctors.

Researchers from the University of Nebraska Medical Center (Omaha, USA) suggest that resistance to vancomycin does not significantly increase mortality in this pathology. A retrospective study was carried out on 113 patients suffering from VRE-induced bacteremia in the hospital from August 1993 to September 2005. All the patients were divided into groups according to the initial antibiotic therapy: 71 patients received treatment on linezolid, 20 received quinupristine-dalphopristine, 22 - a combination of other drugs.

The overall mortality rate was 37.2% (42 of 113 patients died). In 29 of 42 patients (69%), VRE-induced bacteremia was either a direct cause of death or was significantly associated with death.

The unidirectional analysis revealed a significantly higher mortality rate in the quinupristine-dalphopristine group (odds ratio 5.45, 95% confidence interval 1.89-15.9) and in the group of patients receiving a combination of other antimicrobial agents (odds ratio 2.94, 95% confidence interval 1.09-7.94) compared to the linezolid group. However, after adjusting for the severity of the disease, the resulting antimicrobial drug was not a significant independent factor affecting the mortality rate.

The researchers conclude that, despite the creation of new antimicrobial agents with higher activity against VRE, no significant change in clinical outcomes has been observed in patients with bacteremia caused by vancomycin-resistant enterococci. This fact suggests that resistance to vancomycin does not significantly affect mortality and demonstrates the need for prospective randomized clinical trials.