TABLE 1

Baseline characteristics among patients treated with continuous DAP, continuous LZD, or sequential DAP-to-LZD treatment for VREF-BSI, after propensity score matchinga

CharacteristicNo. (%) of patients with characteristic and P valueb for comparison
Continuous treatment (total n)Sequential treatment (total n)
DAP (853)LZD (853)P valueLZD (217)LZD-to-DAP (217)P value
Age ≥ 65 yrs412 (48.3)420 (49.2)0.698101 (50.7)102 (47.0)0.923
Male gender830 (97.3)831 (97.4)0.880209 (96.3)213 (98.2)0.242
Concomitant pneumoniac33 (3.9)30 (3.5)0.70021 (9.7)21 (9.7)>0.999
Facility complexity level
    1a (most complex)606 (71.0)596 (69.9)0.596139 (64.1)129 (59.4)0.323
    1b162 (19.0)148 (17.4)0.37953 (24.4)47 (21.7)0.494
    1c70 (8.2)81 (9.5)0.34822 (10.1)31 (14.3)0.187
    211 (1.3)19 (2.2)0.1412 (0.9)8 (3.7)0.105
    3 (least complex)4 (0.5)9 (1.1)0.1641 (0.5)2 (0.9)>0.999
Yr of infection
    200460 (7.0)77 (9.0)0.13017 (7.8)22 (10.1)0.401
    200583 (9.7)85 (10.0)0.87121 (9.7)26 (12.0)0.440
    200673 (8.6)84 (9.8)0.35726 (12.0)33 (15.2)0.327
    200795 (11.1)107 (12.5)0.36929 (13.4)25 (11.5)0.561
    2008102 (12.0)110 (12.9)0.55726 (12.0)24 (11.1)0.764
    2009104 (12.2)104 (12.2)>0.99923 (10.6)23 (10.6)>0.999
    201085 (10.0)77 (9.0)0.50926 (12.0)15 (6.9)0.071
    201189 (10.4)69 (8.1)0.09516 (7.3)14 (6.5)0.658
    201271 (8.3)55 (6.4)0.13919 (8.8)22 (10.1)0.622
    201362 (7.3)52 (6.1)0.3325 (2.3)4 (1.8)0.522
    201429 (3.4)33 (3.9)0.6059 (4.1)9 (4.1)>0.999
Infectious diseases consultd424 (49.7)421 (49.4)0.884114 (52.5)124 (57.1)0.335
Source of VREF-BSI
    Genitourinary only99 (11.6)96 (11.3)0.81927 (12.4)29 (13.4)0.775
    Abdominal/gastrointestinal only36 (4.2)42 (4.9)0.48711 (5.1)7 (3.2)0.064
    Line-associated only89 (10.4)107 (12.5)0.17212 (5.5)12 (5.5)>0.999
    Endocarditis/cardiac device only57 (6.7)67 (7.9)0.35130 (13.8)29 (13.4)0.889
    Wound/bone only25 (2.9)31 (3.6)0.41512 (5.5)8 (3.7)0.684
    Multiple sources127 (14.9)113 (13.2)0.33039 (18.0)46 (21.2)0.397
    Unknown source420 (49.2)397 (46.5)0.11986 (39.6)86 (39.6)>0.999
Previous VRE stool colonizatione95 (11.1)85 (10.0)0.43119 (8.8)30 (13.8)0.095
Time to treatment (days)f [median (IQR)]3 (2–4)3 (2–4)0.6573 (2–5)3 (2–4)0.489
Concomitant β-lactam treatmentg662 (77.6)653 (76.6)0.604193 (88.9)185 (85.3)0.252
Concomitant aminoglycoside treatmenth90 (10.6)94 (11.0)0.75538 (17.5)33 (15.2)0.516
Intensive care unit admission271 (31.8)272 (31.9)0.95972 (33.2)73 (33.6)0.919
Malignancy
    Any malignancy301 (35.3)292 (34.3)0.684124 (57.1)124 (57.1)>0.999
    Solid tumor194 (22.7)183 (21.5)0.52191 (41.9)91 (41.9)>0.999
    Hematologic186 (21.8)164 (19.2)0.18740 (18.4)51 (23.5)0.195
Solid organ transplant recipient31 (3.6)26 (3.0)0.50113 (6.0)4 (1.8)0.065
    Kidney7 (0.8)8 (0.9)0.7955 (2.3)1 (0.5)0.215
    Liver22 (2.6)17 (2.0)0.4188 (3.7)3 (1.4)0.221
    Lung2 (0.2)0 (0.0)0.5001 (0.5)0 (0.0)>0.999
    Heart2 (0.2)1 (0.1)>0.9990 (0.0)0 (0.0)
Comorbid conditions
    Charlson comorbidity index [median (IQR)]7 (4–9)7 (4–9)0.6726 (4–8)7 (4–9)0.121
    Moderate to severe renal disease444 (52.1)440 (51.6)0.846117 (53.9)112 (51.6)0.631
    Severe liver disease79 (9.3)83 (9.7)0.74126 (12.0)20 (9.2)0.349
    Metastatic solid tumor104 (12.2)110 (12.9)0.66139 (18.0)39 (18.0)>0.999
    HIV infection25 (2.9)29 (3.4)0.5807 (3.2)7 (3.2)>0.999
Neutropenia90 (10.6)82 (9.6)0.52023 (10.6)25 (11.5)0.760
Thrombocytopenia231 (27.1)199 (23.3)0.07460 (27.6)46 (21.1)0.118
APACHE II scorei [median (IQR)]14 (10–17)13 (10–18)0.79013 (9–17)14 (11–18)0.320
  • a Propensity scores were derived from the following covariates: age ≥ 65 years, concomitant pneumonia, facility complexity level, year of infection, infectious diseases consultation, source of VREF-BSI, previous VRE colonization, concomitant β-lactam treatment, intensive care unit admission, malignancy, solid organ transplant, Charlson comorbidity index, moderate or severe renal disease, severe liver disease, neutropenia, and thrombocytopenia.

  • b Categorical variables compared with the chi-square or Fisher's exact test; continuous variables were compared with the Mann-Whitney U test.

  • c Within 72 h of index culture.

  • d Within 48 h of treatment initiation.

  • e Positive VREF stool screening within preceding 90 days; negative culture data not available.

  • f Time from index VREF blood culture to first dose of daptomycin or linezolid.

  • g At least one dose of the following: ampicillin, ampicillin-sulbactam, ticarcillin-clavulanate, aztreonam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, cefepime, ertapenem, meropenem, doripenem, imipenem-cilastatin, or piperacillin-tazobactam.

  • h At least one dose of the following: amikacin, gentamicin, or tobramycin.

  • i APACHE II, Acute Physiology and Chronic Health Evaluation II study.