Vancomycin-resistant Enterococcus infective endocarditis: A case series and review of the literature
Issued Date
2026-09-01
Resource Type
ISSN
12019712
eISSN
18783511
Scopus ID
2-s2.0-105042647881
Pubmed ID
42235917
Journal Title
International Journal of Infectious Diseases
Volume
170
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Infectious Diseases Vol.170 (2026)
Suggested Citation
Cairns K.A., Abbott I.J., Udy A.A., Peel T.N., Spelman D.W., Lee S.J., Rawson-Harris P., Dooley M.J., Peleg A.Y. Vancomycin-resistant Enterococcus infective endocarditis: A case series and review of the literature. International Journal of Infectious Diseases Vol.170 (2026). doi:10.1016/j.ijid.2026.108856 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117726
Title
Vancomycin-resistant Enterococcus infective endocarditis: A case series and review of the literature
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Objectives To describe the epidemiology, management and clinical outcomes of patients with VRE infective endocarditis. Methods We performed a retrospective review of VRE infective endocarditis cases from our institution and the published literature between 2000 and 2024. Predictors of mortality were assessed using univariate and multivariate logistic regression. Results A total of 72 cases were identified (18 local and 54 from the literature) from nine countries. Median age was 60.0 years (IQR: 44.0-69.0), with 64.8% of cases being male. Enterococcus faecium was the most common species (64/72, 88.9%). Presence of a central venous catheter (25/72, 34.7%), requiring haemodialysis (19/72, 26.4%) and underlying diabetes (18/72, 25.0%) were the most commonly reported comorbidities associated with endocarditis. Native cardiac valves were most commonly affected (n = 47/72, 65.3%), with surgical intervention uncommon (21.2%). Nineteen patients (26.4%) were treated with monotherapy, with the remaining 53 patients receiving sequential therapy using 30 different antibiotic combinations. Median treatment duration was 50.0 days (IQR: 31.0-58.0) and the end-of-treatment mortality was 40.8% (n = 29/71). There were no independent predictors of mortality identified. Conclusions VRE endocarditis is an uncommon infection with high mortality. We highlight the diversity in antimicrobial management and importance of further research into this challenging infection.