Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia
A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review....
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| Veröffentlicht in: | Clinical infectious diseases 1997-11, Vol.25 (5), p.1056-1059 |
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| container_title | Clinical infectious diseases |
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| creator | Roghmann, Mary-Claire McCarter, Robert J. Brewrink, Jeanine Cross, Alan S. Morris, J. Glenn |
| description | A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review. One hundred percent of patients with VRE bacteremia (10 of 10) vs. 56% of patients without VRE bacteremia (23 of 41) had acute leukemia (P = .01, Fisher's exact test). Four of the 10 patients with VRE bacteremia had a positive Clostridium difficile toxin assay within 6 days of their first positive VRE blood culture. Both C. difficile infection and antimicrobial (vancomycin and ciprofloxacin) use during VRE colonization were significant risk factors for VRE bacteremia in univariate analysis. When a Cox proportional hazards model was used to account for differences in follow-up time, C. difficile infection was the only statistically significant risk factor (risk ratio, 8.2; P = .007) for VRE bacteremia in VRE-colonized patients with acute leukemia. |
| doi_str_mv | 10.1086/516112 |
| format | Article |
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Glenn</creator><creatorcontrib>Roghmann, Mary-Claire ; McCarter, Robert J. ; Brewrink, Jeanine ; Cross, Alan S. ; Morris, J. Glenn</creatorcontrib><description>A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review. One hundred percent of patients with VRE bacteremia (10 of 10) vs. 56% of patients without VRE bacteremia (23 of 41) had acute leukemia (P = .01, Fisher's exact test). Four of the 10 patients with VRE bacteremia had a positive Clostridium difficile toxin assay within 6 days of their first positive VRE blood culture. Both C. difficile infection and antimicrobial (vancomycin and ciprofloxacin) use during VRE colonization were significant risk factors for VRE bacteremia in univariate analysis. When a Cox proportional hazards model was used to account for differences in follow-up time, C. difficile infection was the only statistically significant risk factor (risk ratio, 8.2; P = .007) for VRE bacteremia in VRE-colonized patients with acute leukemia.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/516112</identifier><identifier>PMID: 9402356</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Acute Disease ; Antibiotics ; Bacteremia ; Bacteremia - complications ; Bacteremia - microbiology ; Biological and medical sciences ; Cancer ; Clinical Articles ; Clostridium difficile ; Clostridium difficile - drug effects ; Clostridium difficile - isolation & purification ; Cohort Studies ; Drug Resistance, Microbial ; Enterococcus - drug effects ; Enterococcus - isolation & purification ; Enterocolitis, Pseudomembranous - complications ; Enterocolitis, Pseudomembranous - drug therapy ; Enterocolitis, Pseudomembranous - microbiology ; Female ; Follow-Up Studies ; Gram-Positive Bacterial Infections - complications ; Gram-Positive Bacterial Infections - microbiology ; Hematologic and hematopoietic diseases ; Humans ; Infections ; Leukemia ; Leukemia - complications ; Leukemia - microbiology ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Middle Aged ; Neutropenia ; Neutropenia - complications ; Predisposing factors ; Risk Factors ; Statistical significance ; Toxins ; Vancomycin - pharmacology</subject><ispartof>Clinical infectious diseases, 1997-11, Vol.25 (5), p.1056-1059</ispartof><rights>Copyright 1997 The University of Chicago</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-b106cfe35139872e8e8ff8072b234f9721b67eb985fceca66e9ef87c3708188a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4460150$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4460150$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27923,27924,58016,58249</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2054658$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9402356$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roghmann, Mary-Claire</creatorcontrib><creatorcontrib>McCarter, Robert J.</creatorcontrib><creatorcontrib>Brewrink, Jeanine</creatorcontrib><creatorcontrib>Cross, Alan S.</creatorcontrib><creatorcontrib>Morris, J. Glenn</creatorcontrib><title>Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review. One hundred percent of patients with VRE bacteremia (10 of 10) vs. 56% of patients without VRE bacteremia (23 of 41) had acute leukemia (P = .01, Fisher's exact test). Four of the 10 patients with VRE bacteremia had a positive Clostridium difficile toxin assay within 6 days of their first positive VRE blood culture. Both C. difficile infection and antimicrobial (vancomycin and ciprofloxacin) use during VRE colonization were significant risk factors for VRE bacteremia in univariate analysis. When a Cox proportional hazards model was used to account for differences in follow-up time, C. difficile infection was the only statistically significant risk factor (risk ratio, 8.2; P = .007) for VRE bacteremia in VRE-colonized patients with acute leukemia.</description><subject>Acute Disease</subject><subject>Antibiotics</subject><subject>Bacteremia</subject><subject>Bacteremia - complications</subject><subject>Bacteremia - microbiology</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Clinical Articles</subject><subject>Clostridium difficile</subject><subject>Clostridium difficile - drug effects</subject><subject>Clostridium difficile - isolation & purification</subject><subject>Cohort Studies</subject><subject>Drug Resistance, Microbial</subject><subject>Enterococcus - drug effects</subject><subject>Enterococcus - isolation & purification</subject><subject>Enterocolitis, Pseudomembranous - complications</subject><subject>Enterocolitis, Pseudomembranous - drug therapy</subject><subject>Enterocolitis, Pseudomembranous - microbiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gram-Positive Bacterial Infections - complications</subject><subject>Gram-Positive Bacterial Infections - microbiology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Infections</subject><subject>Leukemia</subject><subject>Leukemia - complications</subject><subject>Leukemia - microbiology</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neutropenia</subject><subject>Neutropenia - complications</subject><subject>Predisposing factors</subject><subject>Risk Factors</subject><subject>Statistical significance</subject><subject>Toxins</subject><subject>Vancomycin - pharmacology</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1uEzEURi0EKiXAE4DkBUKwGLDHv7Ns05REikQJpSA2luNcCzcz4zL2qJRX4WVxlSgsWVj3Sufos3Q_hJ5T8o4SLd8LKimtH6BjKpiqpGjow7IToSuumX6MnqR0TQilmogjdNRwUjMhj9GfaRtTHsImjB3eBO-DCy3gRe_B5RB7vEjY4lVIW3xuXY4D9uWdlhUG6ILFZyPgHPGV7V3s7lzoqxWkkLLtM571xYouOhfwm6vV7C0OPS6zmsY29uE3bPCFzQH6nPBtyD_wiRsz4CWM2_vsp-iRt22CZ_s5QV_OZ5fTebX8-GExPVlWjjUsV2tKpPPABGWNVjVo0N5roup1zbhvVE3XUsG60cI7cFZKaMBr5Zgimmpt2QS93uXeDPHnCCmbLiQHbWt7iGMyquGyrhX_r0glF5px9U90Q0xpAG9uhtDZ4c5QYu7rMru6ivhynziuO9gctH0_hb_ac5ucbf1QzhzSQauJ4LJ8OUEvdtp1KhUdMOeSUEEKrna49AK_DtgOWyMVU8LMv303F181vZx_OjWf2V-0ybSU</recordid><startdate>19971101</startdate><enddate>19971101</enddate><creator>Roghmann, Mary-Claire</creator><creator>McCarter, Robert J.</creator><creator>Brewrink, Jeanine</creator><creator>Cross, Alan S.</creator><creator>Morris, J. Glenn</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19971101</creationdate><title>Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia</title><author>Roghmann, Mary-Claire ; McCarter, Robert J. ; Brewrink, Jeanine ; Cross, Alan S. ; Morris, J. 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Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neutropenia</topic><topic>Neutropenia - complications</topic><topic>Predisposing factors</topic><topic>Risk Factors</topic><topic>Statistical significance</topic><topic>Toxins</topic><topic>Vancomycin - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roghmann, Mary-Claire</creatorcontrib><creatorcontrib>McCarter, Robert J.</creatorcontrib><creatorcontrib>Brewrink, Jeanine</creatorcontrib><creatorcontrib>Cross, Alan S.</creatorcontrib><creatorcontrib>Morris, J. 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Glenn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>1997-11-01</date><risdate>1997</risdate><volume>25</volume><issue>5</issue><spage>1056</spage><epage>1059</epage><pages>1056-1059</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review. One hundred percent of patients with VRE bacteremia (10 of 10) vs. 56% of patients without VRE bacteremia (23 of 41) had acute leukemia (P = .01, Fisher's exact test). Four of the 10 patients with VRE bacteremia had a positive Clostridium difficile toxin assay within 6 days of their first positive VRE blood culture. Both C. difficile infection and antimicrobial (vancomycin and ciprofloxacin) use during VRE colonization were significant risk factors for VRE bacteremia in univariate analysis. When a Cox proportional hazards model was used to account for differences in follow-up time, C. difficile infection was the only statistically significant risk factor (risk ratio, 8.2; P = .007) for VRE bacteremia in VRE-colonized patients with acute leukemia.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>9402356</pmid><doi>10.1086/516112</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Clinical infectious diseases, 1997-11, Vol.25 (5), p.1056-1059 |
| issn | 1058-4838 1537-6591 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79462274 |
| source | MEDLINE; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals |
| subjects | Acute Disease Antibiotics Bacteremia Bacteremia - complications Bacteremia - microbiology Biological and medical sciences Cancer Clinical Articles Clostridium difficile Clostridium difficile - drug effects Clostridium difficile - isolation & purification Cohort Studies Drug Resistance, Microbial Enterococcus - drug effects Enterococcus - isolation & purification Enterocolitis, Pseudomembranous - complications Enterocolitis, Pseudomembranous - drug therapy Enterocolitis, Pseudomembranous - microbiology Female Follow-Up Studies Gram-Positive Bacterial Infections - complications Gram-Positive Bacterial Infections - microbiology Hematologic and hematopoietic diseases Humans Infections Leukemia Leukemia - complications Leukemia - microbiology Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Middle Aged Neutropenia Neutropenia - complications Predisposing factors Risk Factors Statistical significance Toxins Vancomycin - pharmacology |
| title | Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia |
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