Vancomycin-resistant enterococci infection and predisposing factors for infection and mortality in patients with acute leukaemia and febrile neutropenia

• Published in: Leukemia research 2020-12, Vol.99, p.106463-106463, Article 106463
• Main Authors: Kirkizlar, Tugcan Alp, Akalin, Halis, Kirkizlar, Onur, Ozkalemkas, Fahir, Ozkocaman, Vildan, Kazak, Esra, Ozakin, Cuneyt, Bulbul, Esra Nur, Ozboz, Ezgi Sezen, Ali, Rıdvan
• Format: Article
• Language: English
• Subjects: Acute leukaemia; Adult; Age Factors; Aged; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Bacteremia - drug therapy; Bacteremia - etiology; Bacteremia - microbiology; Cross Infection - drug therapy; Cross Infection - etiology; Cross Infection - microbiology; Cross Infection - mortality; Daptomycin; Daptomycin - therapeutic use; Enterococcus faecium - drug effects; Enterococcus faecium - isolation & purification; febrile neutropenia; Febrile Neutropenia - complications; Female; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - etiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - mortality; Hospital Mortality; Humans; Kaplan-Meier Estimate; Leukemia, Myeloid, Acute - complications; Linezolid; Linezolid - therapeutic use; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Proportional Hazards Models; Retrospective Studies; Risk Factors; Sex Factors; Soft Tissue Infections - drug therapy; Soft Tissue Infections - etiology; Soft Tissue Infections - microbiology; Turkey - epidemiology; Urinary Tract Infections - drug therapy; Urinary Tract Infections - etiology; Urinary Tract Infections - microbiology; Vancomycin - pharmacology; Vancomycin - therapeutic use; Vancomycin Resistance; Vancomycin-resistant enterococcus
• ISSN: 0145-2126; 1873-5835
• DOI: 10.1016/j.leukres.2020.106463

•Vancomycin-resistant enterococcus infections increase morbidity and mortality especially in neutropenic patients.•Pay attention for VRE infection in VRE colonized patients who are coinfected and have >15 days of colonization.•Invasive procedures should be postpone if possible in VRE colonized patients.•Be aware in terms of increased mortality in patients who are older, female, neutropenic and coinfected. Vancomycin-resistant enterococcus (VRE) is an infectious agent that can increase morbidity and mortality, especially in patients with neutropenia in haematology departments. We analysed VRE infections and mortality rates among VRE colonized patients with acute leukaemia, defined predisposing risk factors for infection and mortality, and investigated the influence of daptomycin or linezolid treatment on mortality. We included 200 VRE colonized adult acute leukaemia patients with febrile neutropenia between January 2010 and January 2016. Data were collected from electronic files. There were 179 patients in the colonized group, and 21 patients in the infected group. Enterococcus faecium (van A) was isolated from all patients. The infection rate was 10.5 %, and the types of infections noted were as follows: bloodstream (n = 14; 66.7 %), skin and soft tissue (n = 3; 14.3 %), urinary (n = 2; 9.5 %), and others (9.5 %). In the multivariate logistic regression analysis, exposure to invasive procedures, coinfection status, and >15 days of VRE positivity were independent risk factors for VRE infections. In hospital mortality rates were 57.1 % in the infected group, and 9.5 % in the colonized group (p