| Vancomycin-resistant Enterococcus faecium infection in patients with hematologic malignancy: patients with acute myeloid leukemia are at high-risk. | |
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MedLine Citation:
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PMID: 17655696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens in patients with hematologic malignancy. Identification of risk factors for infection is necessary for targeted prevention and surveillance. OBJECTIVES AND METHODS: An outbreak of VRE infection occurred at a tertiary cancer hospital between 1 August 2003 and 30 June 2005. Infection control measures recommended by the Society for Healthcare Epidemiology of America were used throughout the outbreak period. A matched case-control study was performed to identify risk factors for VRE infection. RESULTS: Fourteen VRE infections (13 episodes of bacteremia, one urinary tract infection) occurred a median of 10.5 d following hospital admission. All were due to Enterococcus faecium vanB. Univariate analysis identified the following variables to be significantly associated with VRE infection: presence of neutropenia, neutropenia >or=7 d, underlying diagnosis of acute myeloid leukemia (AML), and receipt of vancomycin, metronidazole or carbapenem antibiotic therapy in the 30 d prior to infection. On multivariate analysis, an underlying diagnosis of AML [odds ratio (OR), 15.00; P = 0.017] and vancomycin therapy during the previous 30 d (OR, 17.96; P = 0.036) were retained as independent risk factors for infection. CONCLUSIONS: Risk stratification for development of VRE infection is possible for patients with hematologic malignancy. Patients with AML represent a high-risk population, and targeted prevention strategies must include improved antibiotic stewardship, particularly judicious use of vancomycin therapy. |
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Authors:
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Leon J Worth; Karin A Thursky; John F Seymour; Monica A Slavin |
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Publication Detail:
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Type: Journal Article Date: 2007-07-26 |
Journal Detail:
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Title: European journal of haematology Volume: 79 ISSN: 0902-4441 ISO Abbreviation: Eur. J. Haematol. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-16 Completed Date: 2007-11-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703985 Medline TA: Eur J Haematol Country: Denmark |
Other Details:
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Languages: eng Pagination: 226-33 Citation Subset: IM |
Affiliation:
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Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Australia. leon.worth@petermac.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Case-Control Studies Disease Outbreaks Enterococcus faecium* Female Gram-Positive Bacterial Infections / drug therapy, etiology* Hematologic Neoplasms / complications*, drug therapy Humans Leukemia, Myeloid / complications*, drug therapy Male Middle Aged Multivariate Analysis Risk Factors Vancomycin / therapeutic use Vancomycin Resistance* |
| Chemical | |
Reg. No./Substance:
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1404-90-6/Vancomycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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