Incidence of vancomycin-resistant enterococci (VRE) infection in high-risk febrile neutropenic patients colonized with VRE.
OBJECTIVE
This study seeks to determine the incidence of vancomycin-resistant enterococci (VRE) infection in high-risk neutropenic fever patients colonized with VRE and to determine patient characteristics associated with VRE infection.


METHODS
We conducted a retrospective, single-center, unmatched case-control study. Fifty-three VRE-colonized, high-risk patients with neutropenic fever were identified between January 2006 and February 2009. The two most common diagnoses/conditions included acute myeloid leukemia and hematopoietic stem cell transplantation. Data collected included days of neutropenia, days of fever, demographic data, culture results, and antimicrobial therapy.


RESULTS
Twenty of the 53 patients (38%) with VRE colonization developed a VRE infection. The most common VRE infections were bacteremias (26%). The presence of neutropenia lasting longer than 7 days was associated with the development of VRE infection in this high-risk population colonized with VRE. The timeframe to develop VRE infection varied from 1 day to 2 weeks.


CONCLUSIONS
For patients colonized with VRE, approximately 38% of high-risk neutropenic patients developed a VRE infection. This is the first study to specifically evaluate the incidence of VRE infections in febrile neutropenic patients colonized with VRE. Future research into the use and efficacy of empiric VRE coverage is needed.
Bossaer
John B
JB
Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA.
Hall
Philip D
PD
Garrett-Mayer
Elizabeth
E
D000081:Acetamides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D016022:Case-Control Studies; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D017576:Daptomycin / Q000627:therapeutic use; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D005334:Fever / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D023303:Oxazolidinones / Q000627:therapeutic use; D012189:Retrospective Studies; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use; D020713:Vancomycin Resistance
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D002939:Ciprofloxacin; D014640:Vancomycin; D000069349:Linezolid; D017576:Daptomycin