Journal Article

Risk Factors for Development of Vancomycin-Resistant Enterococcal Bloodstream Infection in Patients with Cancer Who Are Colonized with Vancomycin-Resistant Enterococci

Aimee K. Zaas, Xiaoyan Song, Pamela Tucker and Trish M. Perl

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 10, pages 1139-1146
Published in print November 2002 | ISSN: 1058-4838
Published online November 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/342904
Risk Factors for Development of Vancomycin-Resistant Enterococcal Bloodstream Infection in Patients with Cancer Who Are Colonized with Vancomycin-Resistant Enterococci

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Vancomycin-resistant Enterococcus faecium (VRE) is a common nosocomial isolate, especially among patients with cancer. VRE infections have substantial attributable mortality among patients with cancer. The purpose of this study was to identify risk factors for developing bloodstream infection with VRE in patients with cancer who are colonized with VRE. VRE colonization was prospectively identified in 197 patients with cancer during 4-year period, of whom 179 (91%) had complete records for evaluation. Of these 179 patients, 24 (13.4%) developed hospital-acquired VRE bloodstream infections. Risk factors for VRE bloodstream infection included vancomycin use (relative risk [RR], 1.98; 95% confidence interval [CI], 1.25–3.14), diabetes mellitus (RR, 3.91; 95% CI, 1.20–12.77), gastrointestinal procedures (RR, 4.56; 95% CI, 1.05–19.7), and acute renal failure (RR, 3.10; 95% CI, 1.07–8.93). Strategies for preventing VRE bloodstream infection in VRE-colonized patients with cancer should include limiting vancomycin use and, perhaps, gastrointestinal procedures.

Journal Article.  4322 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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