The Changing Epidemiology of Vancomycin-Resistant Enterococcus (VRE) Bacteremia in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients

Autor: Kent A. Sepkowitz, Mini Kamboj, Eric G. Pamer, Genovefa A. Papanicolaou, Susan K. Seo, Dick Chung, Ann A. Jakubowski
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
Adolescent
VRE
medicine.medical_treatment
T-Lymphocytes
Bacteremia
Drug resistance
Hematopoietic stem cell transplantation
Preengraftment bacteremia
Neutropenia
medicine.disease_cause
Article
Lymphocyte Depletion
Young Adult
immune system diseases
Risk Factors
Vancomycin
Internal medicine
hemic and lymphatic diseases
Drug Resistance
Bacterial
medicine
Humans
Vancomycin-resistant Enterococcus
Screening cultures
Aged
Retrospective Studies
Transplantation
business.industry
Hematopoietic Stem Cell Transplantation
Retrospective cohort study
Hematology
biochemical phenomena
metabolism
and nutrition
Middle Aged
medicine.disease
bacterial infections and mycoses
Allogeneic transplant
Gastrointestinal Tract
surgical procedures
operative
Hematologic Neoplasms
Immunology
Female
business
Enterococcus
medicine.drug
Popis: The impact of the rising prevalence of vancomycin-resistant Enterococcus (VRE) prior to hematopoietic stem cell transplantation (HSCT) and changes in transplant techniques on risk of VREB (VRE bacteremia) early after HSCT is not known. This is a retrospective study of 247 adult patients who underwent allogeneic HSCT in the years 2008 and 2009 at the Memorial Sloan-Kettering Cancer Center. Sixty-eight of 247 (27.5%) patients were VRE colonized on pretransplant screening. VRE was the leading cause of bacteremia in the first 30 days after HSCT; 23 of 43 (53.5%) patients with positive blood cultures had VRE. Only 13 (57%) of the 23 patients with early VREB were colonized with VRE on pre-HSCT screening cultures. Mortality was directly attributable to VRE infection in 9% of patients with early VREB. VRE is emerging as the most common cause of preengraftment bacteremia in patients undergoing allogeneic HSCT, and is associated with substantial mortality. Pre-HSCT screening for VRE with stool cultures will not identify all patients who are at risk for VREB. The use of alternate agents with activity against Gram-positive bacteria for fever and neutropenia early after HSCT should be evaluated further in prospective studies.
Databáze: OpenAIRE
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