Vancomycin-resistant enterococci colonization and bacteremia in patients with hematological malignancies

Area of Science:

• Infectious Diseases
• Hematology
• Oncology

Background:

• Vancomycin-resistant enterococci (VRE) pose a significant threat in healthcare settings.
• Patients with hematological malignancies are particularly vulnerable to VRE colonization and infection due to their immunocompromised state.

Purpose of the Study:

• To evaluate the incidence of VRE colonization and VRE-related infections in patients undergoing chemotherapy for hematological malignancies.
• To identify risk factors associated with VRE bacteremia in this patient population.

Main Methods:

• Retrospective observational study of 126 patients with hematological cancers and febrile neutropenia.
• Data collected from November 2010 to November 2012 at a tertiary hospital in İstanbul, Turkey.
• Analysis of 282 neutropenic episodes, focusing on VRE colonization and bacteremia rates.

Main Results:

• VRE colonization was observed in 39.68% of patients, with a mean colonization duration of 34.27 days.
• Two cases of VRE bacteremia occurred: one survivor and one fatality in a patient with acute myeloid leukemia.
• High Multinational Association for Supportive Care in Cancer score was noted in patients with hematological malignancies.

Conclusions:

• VRE colonization in hematological malignancy patients increases the risk of VRE bacteremia.
• Severe mucositis, invasive procedures, and intensive broad-spectrum antibiotic use are critical conditions for developing VRE bacteremia.
• Effective infection control measures are crucial, but vigilance for VRE bacteremia is necessary even with proper implementation.