The emergence of vancomycin-resistant enterococcal bacteremia in hematopoietic stem cell transplant recipients

Michael J. Satlin, Rosemary Soave, Alexandra C. Racanelli, Tsiporah B. Shore, Koen Van Besien, Stephen G. Jenkins, Thomas J. Walsh

Research output: Contribution to journalArticlepeer-review

Abstract

As antimicrobial resistance increases, understanding the current epidemiology of bloodstream infections (BSIs) in hematopoietic stem cell transplant (HSCT) recipients is essential to guide empirical antimicrobial therapy. We therefore reviewed microbial etiologies, timing and outcomes of BSIs in patients who were transplanted from September 2007 to December 2011. Vancomycin-resistant enterococci (VRE) were the most common pathogens in allogeneic HSCT recipients and the fourth most common after autologous transplant. VRE did not cause any of 101 BSIs in neutropenic patients who were not receiving antibacterials, but caused 32 (55%) of 58 BSIs in neutropenic patients receiving a broad-spectrum β-lactam agent (p < 0.001). Rates of septic shock and 7-day mortality were 5% and 0% for streptococcal bacteremia, 12% and 18% for VRE bacteremia, and 20% and 14% for Gram-negative bacteremia. In conclusion, VRE bacteremia was the most common BSI in allogeneic HSCT recipients, occurred primarily in neutropenic patients receiving broad-spectrum β-lactams and was associated with poor outcomes.

Original languageEnglish (US)
Pages (from-to)2858-2865
Number of pages8
JournalLeukemia and Lymphoma
Volume55
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Bloodstream infections
  • Hematopoietic stem cell transplant recipients
  • Vancomycin-resistant enterococci

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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