Vancomycin-resistant enterococci infection: not just for the transplanted.

Area of Science:

• Infectious Diseases
• Hematology
• Transplant Medicine

Background:

• Vancomycin-resistant enterococcal (VRE) bloodstream infections (BSIs) present significant risks for patients with hematologic malignancies.
• Understanding VRE BSI epidemiology and outcomes in hematopoietic cell transplant (HCT) recipients versus non-HCT patients is crucial.

Purpose of the Study:

• To compare VRE BSI rates, patient characteristics, and clinical outcomes between HCT and non-HCT patient cohorts.
• To assess the impact of VRE BSIs on morbidity and mortality in immunocompromised patients.

Main Methods:

• Retrospective analysis of consecutive patients from 1998-2011 at a single institution.
• Comparison of VRE BSI incidence, patient demographics, and treatment exposures between HCT and non-HCT groups.

Main Results:

• VRE accounted for 14% of BSIs in HCT patients (1.9% cumulative rate) and 10% in non-HCT patients (1.1% cumulative rate).
• HCT patients with VRE BSI were younger, had more frequent hospitalizations, and higher vancomycin exposure.
• 22 deaths were attributed directly or indirectly to VRE infections, highlighting significant morbidity and mortality.

Conclusions:

• Both HCT and non-HCT patients are susceptible to VRE infections and share similar risks for adverse outcomes.
• VRE remains a critical cause of morbidity and mortality in patients with hematologic malignancy, necessitating vigilant management strategies.