Document Detail


Vancomycin-resistant Enterococcus faecium infection in patients with hematologic malignancy: patients with acute myeloid leukemia are at high-risk.
MedLine Citation:
PMID:  17655696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Leon J Worth; Karin A Thursky; John F Seymour; Monica A Slavin
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Publication Detail:
Type:  Journal Article     Date:  2007-07-26
Journal Detail:
Title:  European journal of haematology     Volume:  79     ISSN:  0902-4441     ISO Abbreviation:  Eur. J. Haematol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  226-33     Citation Subset:  IM    
Affiliation:
Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Australia. leon.worth@petermac.org
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MeSH Terms
Descriptor/Qualifier:
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:
1404-90-6/Vancomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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