Colonization and infection with vancomycin-resistant enterococcus among patients with cancer

Matar, Madonna; Tarrand, Jeffrey; Raad, Issam; Rolston, Kenneth V. I.

doi:10.1016/j.ajic.2006.04.205

Cited by 97 publications

(76 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reported VRE colonization rates among hospitalized patients vary widely, ranging from 1.5% to 32%, while the prevalence of VRE among non-hospitalized patients is 1-3.5%, usually involving non-epidemic isolates 11,14,[20][21][22] . Futardo et al 7) reported that the incidence of VRE in neurosurgical department was from 2% to 6%.…”

Section: Incidence Of Vre Infection In Neurosurgical Practicementioning

confidence: 99%

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

et al. 2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). Methods : This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. Results : A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3 % of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. Conclusion : When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

show abstract

Section: Incidence Of Vre Infection In Neurosurgical Practicementioning

confidence: 99%

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

et al. 2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…Mortality is more likely in patients with comorbidities, patients over the age of 75 years, patients residing in the ICU at bacteremia onset, patients with a non-urinary tract infection bacteremia focus and patients admitted with severe sepsis [19]. VRE colonization rates among our patients (30 %) were higher than those reported among patients with hematopoietic stem cell transplantation (HSCT) (27.5 %) and among patients with cancer (4.7 %) [20,21]. The unfavorable conditions in our ward (e.g., shared toilets, housing of patients with their attendants, etc.)…”

Section: Discussionmentioning

confidence: 58%

Which Multidrug-Resitant Bacteria are Emerging in Patients with Hematological Malignancies?: One-Year Report

Gedık

Şimşek²,

Yıldırmak³

et al. 2014

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

The aim of this retrospective, observational study was to evaluate the outcomes of bacteremia attacks during neutropenic episodes caused by chemotherapy in patients with hematological cancers by assessing mortality, involved pathogens, antimicrobial therapy and treatment responses. Patients who were older than 14 years of age and developed at least one neutropenic episode after chemotherapy to treat hematological cancer between November 2011 and November 2012 were included in the study. We retrospectively collected demographic, treatment, and survival data for 68 patients with 129 neutropenic episodes. The mean age was 59.36 ± 15.22 years (range 17-80 years), and 41 cases were male. The mean Multinational Association of Supportive Care in Cancer score was 19.56 ± 9.04. A total of 37 (28 %) bacteremia attacks were recorded in 20 cases (29 %). Fatality rates were 50 % in the six cases with bacteremia caused by carbapenem-resistant Gram-negative bacteria; death occurred in two patients with carbapenem-resistant Acinetobacter baumannii and in one patient with carbapenem-resistant Pseudomonas aeruginosa. Clinical and microbiological responses were achieved using PIP-TAZ or CEP-SUL treatment in 80 % (16/20) of the cases with bacteremia caused by carbapenem-sensitive Gram-negative bacteria (CS-GNB). During 547 colonization-days in 21 (30 %) vancomycinresistant enterococci (VRE)-colonized cases among 68 patients, vancomycin-resistant Enterococcus faecium bacteremia developed in two patients. Non-carbapenem-based therapy can cure most bacteremia attacks caused by CS-GNB in patients with hematological cancer. However, bacteremia and other infections caused by drug-resistant pathogens, such as A. baumannii, P. aeruginosa, and VRE, are a growing concern in hematological patients.

show abstract

“…Other common risk factors, such as cancer or other immunosuppressive diseases, were not clearly associated with colonization or infection in our study (p = 0.064), although cancer prevailed in VRE-infected patients in relation to the colonized. The literature shows that VRE-colonized patients who experience febrile neutropenia are at a higher risk of developing a VRE infection than the general hospitalized population, probably because of the higher levels of immunosuppressants and broad-spectrum antimicrobials used in these patients 23 .…”

Section: Resultsmentioning

confidence: 99%

Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital

Rossini

Fagnani

Leichsenring

et al. 2012

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE.

show abstract

Colonization and infection with vancomycin-resistant enterococcus among patients with cancer

Cited by 97 publications

References 10 publications

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

Which Multidrug-Resitant Bacteria are Emerging in Patients with Hematological Malignancies?: One-Year Report

Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital

Contact Info

Product

Resources

About