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Vancomycin-Resistant Enterococcus faecium Bacteremia: Risk Factors for Infection
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Vancomycin-Resistant Enterococcus faecium Bacteremia: Risk Factors for Infection
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Journal Article
Vancomycin-Resistant Enterococcus faecium Bacteremia: Risk Factors for Infection
1995
Overview
We describe an outbreak of vancomycin-resistant Enterococcus faecium (vanA phenotype) bacteremia on the oncology ward of a tertiary care community hospital. In 10 of the 11 cases the patients had leukemia and were neutropenic (median duration of neutropenia, 21 days) at the time of bacteremia. On average, patients received six antibiotic agents for a total of 61 agent-days prior to development of vancomycin-resistant E. faecium bacteremia. The mortality rate was 73%. Molecular typing of 22 isolates revealed that the majority (83%) represented a common strain, indicating nosocomial spread. When the 11 cases were compared to 22 matched control patients, gastrointestinal colonization with vancomycin-resistant E. faecium (odds ratio [denominator, 0] ∞, P = .005) and the use of antimicrobial agents with significant activity against anaerobes (metronidazole, clindamycin, and imipenem; odds ratio ∞, P= .02) were found to be risk factors for the development of vancomycin-resistant E. faecium bacteremia. Since no proven therapy for such infection exists, there is an urgent need to identify effective measures to prevent and control the development of vancomycin-resistant E. faecium bacteremia.
Publisher
The University of Chicago Press,University of Chicago Press
Subject
/ Aged
/ Biological and medical sciences
/ Blood
/ Enterococcus faecium - drug effects
/ Female
/ Gram-Positive Bacterial Infections - drug therapy
/ Gram-Positive Bacterial Infections - epidemiology
/ Gram-Positive Bacterial Infections - etiology
/ Humans
/ Male
/ Oncology
