Heisel Ronald W, Sutton Robert R, Mascara Gerard P, Winger Daniel G, Weber David R, Lim Seah H, Oleksiuk Louise-Marie
a Department of Pharmacy , University of Pittsburgh Medical Center , Pittsburgh , PA , USA.
b University of Pittsburgh School of Pharmacy , Pittsburgh , PA , USA.
Leuk Lymphoma. 2017 Nov;58(11):2565-2572. doi: 10.1080/10428194.2017.1306645. Epub 2017 Mar 28.
We conducted a retrospective study to determine the risk factors associated with vancomycin-resistant enterococci (VRE) acquisition/infection in newly diagnosed acute myeloid leukemia and myelodysplastic syndrome patients undergoing chemotherapy with the 7 + 3 regimen of cytarabine and idarubicin. Although only 2.5% (6/235) patients were colonized with VRE on admission, 59% (134/229) of patients acquired VRE during their hospitalization. Multivariable analysis identified the use of intravenous vancomycin (p = .024; HR: 1.548) and cephalosporin (p = .009; HR: 1.596) as the risk factors for VRE acquisition. VRE infection developed in 14% (33/229) of patients, with bloodstream infections accounting for 82% (27/33) of cases. VRE infection occurred in 25/126 (20%) of the VRE-colonized patients, but only 8/103 (8%) of those who were not (p = .01). Our study provides the evidence for the role of intravenous cephalosporin and vancomycin in VRE acquisition and highlights the clinical significance of VRE colonization in these patients.
我们进行了一项回顾性研究，以确定在接受阿糖胞苷和伊达比星7+3方案化疗的新诊断急性髓系白血病和骨髓增生异常综合征患者中，与耐万古霉素肠球菌（VRE）获得/感染相关的危险因素。尽管入院时只有2.5%（6/235）的患者被VRE定植，但59%（134/229）的患者在住院期间获得了VRE。多变量分析确定静脉使用万古霉素（p = 0.024；HR：1.548）和头孢菌素（p = 0.009；HR：1.596）是VRE获得的危险因素。14%（33/229）的患者发生了VRE感染，其中血流感染占82%（27/33）。VRE定植患者中有25/126（20%）发生了VRE感染，但未定植患者中只有8/103（8%）发生了感染（p = 0.01）。我们的研究为静脉使用头孢菌素和万古霉素在VRE获得中的作用提供了证据，并突出了VRE定植在这些患者中的临床意义。
