التفاصيل البيبلوغرافية
| العنوان: |
Vancomycin-resistant Enterococcus colonization and bloodstream infection: prevalence, risk factors, and the impact on early outcomes after allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. |
| المؤلفون: |
Hefazi, Mehrdad, Damlaj, Moussab, Alkhateeb, Hassan B., Partain, Daniel K., Patel, Robin, Razonable, Raymund R., Gastineau, Dennis A., Al‐Kali, Aref, Hashmi, Shahrukh K., Hogan, William J., Litzow, Mark R., Patnaik, Mrinal M. |
| المصدر: |
Transplant Infectious Disease; Dec2016, Vol. 18 Issue 6, p913-920, 8p |
| مصطلحات موضوعية: |
ENTEROCOCCAL infections, HOMOGRAFTS, VANCOMYCIN resistance, HEMATOPOIETIC stem cell transplantation, CELL transplantation, DISEASE risk factors |
| مستخلص: |
Background: Screening for vancomycin-resistant Enterococcus (VRE) is performed at many transplant centers, but data on the impact of VRE colonization and bloodstream infection (BSI) on hematopoietic cell transplantation (HCT) outcomes remain conflicting. Methods: Consecutive adults with acute myeloid leukemia who underwent allogeneic HCT between 2004 and 2014 were retrospectively reviewed. Patients were screened by perirectal PCR swabs targeting vanA and vanB twice weekly while inpatient. Results: Of a total of 203 patients (median age 54 years), 73 (36%) were VRE colonized prior to HCT, 23 (11%) became colonized within the first 100 days, and 107 (53%) remained non-colonized through day 100 post HCT. A landmark analysis on HCT day 0 revealed no significant difference in overall survival according to pre-transplant colonization status (P=.20). However, patients with subsequent VRE colonization within the first 100 days of HCT had a significantly worse survival on both univariable (P=.04) and multivariable (P=.03) analyses. During the first 30 days post HCT, 11 (5% of total and 11% of the VRE colonized) patients developed VRE BSI. Ten (91%) of these had screened positive for VRE colonization before the bacteremia. Age ⩾60 years, HCT-comorbidity index ⩾3, and VRE colonization were independent risk factors for VRE BSI on multivariable analysis (P=.04, .03, .003, respectively). Only 1 (9%) patient with VRE BSI died within the first 100 days post HCT. Conclusion: VRE colonization is a surrogate marker and not an independent predictor of worse outcomes post HCT. VRE BSI is associated with increased morbidity, but does not impact post-HCT survival. [ABSTRACT FROM AUTHOR] |
|
Copyright of Transplant Infectious Disease is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
