title: Vancomycin-resistant enterococci colonization in patients with hematological malignancies: screening and its cost-effectiveness.
abstract: OBJECTIVE
  We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRE-related bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness.
  
  
  METHODS
  All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively.
  
  
  RESULTS
  We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay.
  
  
  CONCLUSIONS
  In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Habip
authors.initials: H
authors.lastname: Gedik
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Funda
authors.initials: F
authors.lastname: Şimşek
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Arzu
authors.initials: A
authors.lastname: Kantürk
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Taner
authors.initials: T
authors.lastname: Yıldırmak
authors.affiliation: Department of Hematology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Deniz
authors.initials: D
authors.lastname: Arıca
authors.affiliation: Department of Hematology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Demet
authors.initials: D
authors.lastname: Aydın
authors.affiliation: Department of Hematology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Osman
authors.initials: O
authors.lastname: Yokuş
authors.affiliation: Department of Hematology, Ministry of Health Okmeydanı Training and Research Hospital, Istanbul.
authors.forename: Naciye
authors.initials: N
authors.lastname: Demirel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015169:Colony Count, Microbial / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D005260:Female; D005334:Fever / Q000209:etiology; D016908:Gram-Positive Bacterial Infections; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D014640:Vancomycin / Q000627:therapeutic use*; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Hematological patients; bacteremia; colonization; febrile neutropenia; vancomycin-resistant enterococci; vancomycin-sensitive enterococci
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