Matar Madonna J, Tarrand Jeffrey, Raad Issam, Rolston Kenneth V I
Department of Infectious Diseases, Infection Control, and Employee Health, Houston, TX 77030, USA.
Am J Infect Control. 2006 Oct;34(8):534-6. doi: 10.1016/j.ajic.2006.04.205.
Vancomycin-resistant enterococci (VRE) cause substantial morbidity and mortality in immune-suppressed patients. In a retrospective review, VRE fecal colonization was documented in 4.7% (99 of 2115) of patients screened, with 5.4% of patients with leukemia, 4.9% of hematopoietic stem cell transplantation recipients, and 2.2% of patients with lymphoma being colonized. Among the 99 patients with VRE colonization, 29 (29.29%) developed bacteremia, and there were 32 episodes of VRE infection at other sites. The rate of VRE bacteremia in solid tumor patients (0.12%) was significantly lower (P <or= .0001). VRE colonization had a negative predictive value of 99.9% and a positive predictive value of 29.3% for the development of VRE bacteremia and might help identify a high-risk subset of patients that might benefit from preemptive VRE therapy during episodes of neutropenic fever.
耐万古霉素肠球菌（VRE）在免疫抑制患者中可导致严重的发病和死亡。在一项回顾性研究中，经筛查的患者中有4.7%（2115例中的99例）记录有VRE粪便定植，其中白血病患者的定植率为5.4%，造血干细胞移植受者为4.9%，淋巴瘤患者为2.2%。在99例VRE定植患者中，29例（29.29%）发生菌血症，其他部位有32次VRE感染发作。实体瘤患者的VRE菌血症发生率（0.12%）显著较低（P≤0.0001）。VRE定植对于VRE菌血症发生的阴性预测值为99.9%，阳性预测值为29.3%，可能有助于识别在中性粒细胞减少性发热发作期间可能从VRE抢先治疗中获益的高危患者亚组。
