Colonization and infection with vancomycin-resistant Enterococcus among patients with cancer.
Vancomycin-resistant enterococci (VRE) cause substantial morbidity and mortality in immune-suppressed patients. In a retrospective review, VRE fecal colonization was documented in 4.7% (99 of 2115) of patients screened, with 5.4% of patients with leukemia, 4.9% of hematopoietic stem cell transplantation recipients, and 2.2% of patients with lymphoma being colonized. Among the 99 patients with VRE colonization, 29 (29.29%) developed bacteremia, and there were 32 episodes of VRE infection at other sites. The rate of VRE bacteremia in solid tumor patients (0.12%) was significantly lower (P <or= .0001). VRE colonization had a negative predictive value of 99.9% and a positive predictive value of 29.3% for the development of VRE bacteremia and might help identify a high-risk subset of patients that might benefit from preemptive VRE therapy during episodes of neutropenic fever.
Matar
Madonna J
MJ
Department of Infectious Diseases, Infection Control, and Employee Health, Houston, TX 77030, USA. madonne@inco.com.lb
Tarrand
Jeffrey
J
Raad
Issam
I
Rolston
Kenneth V I
KV
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000382:microbiology; D016983:Enterococcus / Q000187:drug effects*; D005243:Feces / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D007938:Leukemia / Q000150:complications; D008223:Lymphoma / Q000150:complications; D009369:Neoplasms / Q000150:complications*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013223:Statistics as Topic; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D014640:Vancomycin