کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5566741 | 1563447 | 2017 | 7 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: A polyclonal outbreak of bloodstream infections by Enterococcus faecium in patients with hematologic malignancies A polyclonal outbreak of bloodstream infections by Enterococcus faecium in patients with hematologic malignancies](/preview/png/5566741.png)
BackgroundEnterococcus faecium causes bloodstream infection (BSI) in patients with hematologic malignancies (HMs). We studied the clinical features and outcomes of patients with HM with vancomycin-sensitive E faecium (VSE) and vancomycin-resistant E faecium (VRE) BSI and determined the genetic relatedness of isolates and circumstances associated with the upsurge of E faecium BSI.MethodsCase-control study of patients with HM and E faecium-positive blood culture from January 2008-December 2012; cases were patients with VRE and controls were VSE isolates. The strains were tested for Van genes by polymerase chain reaction amplification and we performed pulsed-field gel electrophoresis to determine genetic relatedness.ResultsFifty-eight episodes of E faecium BSI occurred: 35 sensitive and 23 resistant to vancomycin. Mortality was 46% and 57%, attributable 17% and 40%, respectively. Early stage HM was associated with VSE (Pâ=â.044), whereas an episode of BSI within the 3 months before the event (Pâ=â.039), prophylactic antibiotics (Pâ=â.013), and vancomycin therapy during the previous 3 months (Pâ=â.001) was associated with VRE. The VanA gene was identified in 97% of isolates studied. E faecium isolates were not clonal.ConclusionsE faecium BSI was associated with high mortality. This outbreak of VRE was not clonal; it was associated with antibiotic-use pressure and highly myelosuppressive chemotherapy.
Journal: American Journal of Infection Control - Volume 45, Issue 3, 1 March 2017, Pages 260-266