Vancomycin-resistant enterococcus infection in the hematopoietic stem cell transplant recipient: an overview of epidemiology, management, and prevention

Abstract

Vancomycin-resistant enterococcus (VRE) is now one of the leading causes of nosocomial infections in the United States. Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk of VRE colonization and infection. VRE has emerged as a major cause of bacteremia in this population, raising important clinical questions regarding the role and impact of VRE colonization and infection in HSCT outcomes as well as the optimal means of prevention and treatment. We review here the published literature and scientific advances addressing these thorny issues and provide a rational framework for their approach.

Comparative Efficacies of Linezolid vs. Tedizolid in an Experimental Murine Model of Vancomycin-Resistant Enterococcal (VRE) Bacteremia

“…Infections caused by enterococci (especially VRE strains) are major problems worldwide (1–4). VRE strains, particularly in immunocompromised patients, are a major and steadily increasing cause of bacteremia (5). VRE bloodstream infections ( VRE-BSI ) rank as one of the top four major infections among hospitalized patients (5).…”

“…VRE strains, particularly in immunocompromised patients, are a major and steadily increasing cause of bacteremia (5). VRE bloodstream infections ( VRE-BSI ) rank as one of the top four major infections among hospitalized patients (5). Commonly used antimicrobial agents used to treat VRE-BSI infections, such as daptomycin, oritavancin, dalbavancin, quinupristin-dalfopristin, and tigecycline, each have a number of important side effects, both acutely and more long-term (2).…”

A suspected septic transfusion reaction associated with posttransfusion contamination of a platelet pool by vancomycin‐resistant Enterococcus faecium

“…As described above, the patient was at risk for VRE bacteremia because he was admitted to an ICU, had cancer, and was known to be colonized with VRE . A recent review identifies VRE as a leading cause of bloodstream infections in allogeneic stem cell transplant patients . While this occurs most commonly in the early posttransplant period, VRE bacteremia has also been described in stem cell transplant recipients with relapsed hematologic malignancy …”

Aztreonam and Vancomycin for Initial Treatment of Febrile Neutropenia in Penicillin-Allergic Patients During Hematopoietic Stem Cell Transplantation

“…Reports from other transplant centers show similar rates of colonization, but are more discordant with respect to the rates of VRE conversion from colonization to bacteremia, depending largely upon patient risk factors. Interestingly, others have found VRE colonizers are not only at higher risk for VRE bacteremia, but also possibly bacteremia from other organisms ( Benamu & Deresinski, 2018 ; Ford et al, 2017 ; Webb et al, 2017 ).…”