title: Association between mucositis severity and vancomycin-resistant enterococcal bloodstream infection in hospitalized cancer patients.
abstract: OBJECTIVE
  To determine the role of mucositis severity in the development of vancomycin-resistant enterococcal (VRE) bloodstream infection (BSI).
  
  
  METHODS
  A tertiary-care university medical center.
  
  
  METHODS
  Hematology-oncology-unit inpatients.
  
  
  METHODS
  Patients with VRE BSI (case-patients) were compared with VRE-colonized (control) patients from September 1994 through August 1997. Oral mucositis severity was recorded on the day of VRE BSI for case-patients and on hospital day 22 (median day of hospitalization of case-patient VRE BSI) for controls. There were 19 case-patients and 31 controls.
  
  
  RESULTS
  In univariate analysis, case-patients were significantly more likely than controls to have a higher mucositis severity score, diarrhea, or a higher severity of illness score. In multivariate analysis, only mucositis remained as an independent risk factor, and increasing mucositis score was significantly associated with VRE BSI.
  
  
  CONCLUSIONS
  Mucositis severity was independently associated with an increasing risk for VRE BSI. Interventions to alter mucositis severity may help to prevent VRE BSI in hospitalized cancer patients.
authors.affiliation: Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kuehnert
authors.forename: J A
authors.initials: JA
authors.lastname: Jernigan
authors.forename: A L
authors.initials: AL
authors.lastname: Pullen
authors.forename: D
authors.initials: D
authors.lastname: Rimland
authors.forename: W R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: D018806:APACHE; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D005845:Georgia / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D009369:Neoplasms / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013280:Stomatitis / Q000453:epidemiology / Q000382:microbiology*; D020713:Vancomycin Resistance