Turkish Journal of Hematology Volume: 33 - Issue: 3

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Aktürk H, et al: Vancomycin-Resistant Enterococci Infections in Pediatric Malignancies Turk J Hematol 2016;33:244-247 tract infection in one patient and meningitis in one patient. Enterococcus faecium was isolated in all patients with VRE-I. The mean duration of time from identification of VRE colonization to development of a VRE infection was 32.4±8.6 days (median: 25 days, range: 10-73 days). Univariate analysis of demographic and clinical variables associated with development of VRE-I among patients with VRE-C is presented in Table 1. Duration of neutropenia was significantly longer in patients with VRE-I than in patients with VRE-C (12.8±1.4 days vs. 38.5±7.3 days; p=0.016). Similarly, total parenteral nutritional support was found to be received for a longer time by patients with VRE-I (9.37±0.8 days vs. 15.33±5.5 days; p=0.04). Antimicrobials used among patients are shown in Table 2. Four out of seven patients were receiving a glycopeptide antibiotic when a systemic VRE infection was diagnosed. Multivariate analysis revealed severe neutropenia and history of previous bacteremia with another pathogen as independent risk factors for development of VRE infection in a VRE-colonized patient with cancer (Table 3). All VRE infections were treated with linezolid. No VREattributable deaths occurred during systemic VRE infections. However, crude mortality was higher in patients who suffered from VRE infection than those who did not (2/7 (28.6%) vs. 4/65 (6.2%), respectively; p=0.04). Discussion Overall, 31.4% of patients admitted to our hematology/oncology ward were colonized with VRE. Colonization rates in other studies ranged from 4.7% to 38% [4,5,6,7]. Systemic VRE infections develop mostly in VRE-colonized patients [8,9], although some contrary cases may exist rarely [5,10]. In this study, about 1 in 10 VRE-colonized patients developed subsequent systemic VRE infection (9.7%). Studies evaluating cancer patients reported a range of 13% to 61% rate of progression of VRE colonization to VRE bacteremia [6,10,11,12,13]. Results of univariate analysis revealed some risk factors associated with VRE-I development. One of them was severe neutropenia (
Turk J Hematol 2016;33:244-247 Aktürk H, et al: Vancomycin-Resistant Enterococci Infections in Pediatric Malignancies Table 3. Multivariate analysis of risk factors for development of vancomycin-resistant enterococci infection in patients colonized with vancomycin-resistant enterococci. Variables p OR (95% CI) Severe neutropenia (
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Volume 33 Issue 3 September 2016 80
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Contact Information Editorial Corre
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TURKISH JOURNAL OF HEMATOLOGY INSTR
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have published research articles on
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is provided. Each page has a “Get
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251 A Case of Superwarfarin Poisoni
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BİLİMSEL SEKRETERYA Kongre Sekret
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RESEARCH ARTICLE DOI: 10.4274/tjh.2
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