The changing epidemiology of vancomycin-resistant Enterococcus (VRE) bacteremia in allogeneic hematopoietic stem cell transplant (HSCT) recipients Journal Article

   


Authors: Kamboj, M.; Chung, D.; Seo, S. K.; Pamer, E. G.; Sepkowitz, K. A.; Jakubowski, A. A.; Papanicolaou, G.
Article Title: The changing epidemiology of vancomycin-resistant Enterococcus (VRE) bacteremia in allogeneic hematopoietic stem cell transplant (HSCT) recipients
Abstract: 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. © 2010 American Society for Blood and Marrow Transplantation.
Keywords: adolescent; adult; treatment outcome; aged; middle aged; retrospective studies; young adult; major clinical study; clinical feature; mortality; neutropenia; t-lymphocytes; risk factors; hematopoietic stem cell transplantation; risk factor; time factors; dyspnea; fever; confusion; drug resistance, bacterial; hematologic neoplasms; mental disease; allogeneic hematopoietic stem cell transplantation; bacteremia; enterococcus; bloodstream infection; vancomycin resistant enterococcus; linezolid; vancomycin; gastrointestinal tract; quinoline derived antiinfective agent; lymphocyte depletion; graft recipient; enterococcal infection; allogeneic transplant; preengraftment bacteremia; vre; blood culture; feces culture
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 16
Issue: 11
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2010-11-01
Start Page: 1576
End Page: 1581
Language: English
DOI: 10.1016/j.bbmt.2010.05.008
PUBMED: 20685257
PROVIDER: scopus
PMCID: PMC3670412
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-77957753370&partnerID=40&md5=4b46f6e1640439978615769aa294c69d
Notes: --- - "Export Date: 20 April 2011" - "CODEN: BBMTF" - "Source: Scopus"
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MSK Authors
  1. Kent A Sepkowitz
    272 Sepkowitz
  2. Susan Seo
    120 Seo
  3. Eric Pamer
    283 Pamer
  4. Genovefa A Papanicolaou
    238 Papanicolaou
  5. Mini Kamboj
    158 Kamboj
  6. Ann Jakubowski
    455 Jakubowski
  7. Dick Chung
    13 Chung
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