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Catheter-Related Vancomycin-Resistant Enterococcus Faecium Bacteremia: Clinical and Molecular Epidemiology

Published online by Cambridge University Press:  21 June 2016

Issam I. Raad ,
Hend A. Hanna ,
Maha Boktour ,
Noel Jabbour ,
Ray Y. Hachem  and
Rabih O. Darouiche
Issam I. Raad*
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
Hend A. Hanna
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
Maha Boktour
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
Noel Jabbour
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
Ray Y. Hachem
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
Rabih O. Darouiche
Affiliation:
Center for Prosthesis Infection, Baylor College of Medicine, Houston, Texas
*
The University of Texas M. D. Anderson Cancer Center, Department of Infectious Diseases, Infection Control and Employee Health (Unit 402), 1515 Holcombe Blvd., Houston, TX 77030.[email protected]
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Abstract

Objective:

To study the clinical and molecular epidemiology of vancomycin-resistant Enterococcus faecium organisms causing catheter-related bacteremia in patients with cancer.

Design:

Retrospective case-control study.

Setting:

University of Texas M. D. Anderson Cancer Center, a tertiary-care hospital in Houston, Texas.

Patients:

Case-patients were patients with cancer who had catheter-related vancomycin-resistant E. faecium bacteremia and control-patients were patients with cancer and vancomycin-resistant E. faecium gastrointestinal colonization without infection.

Results:

Ten case-patients with catheter-related vancomycin-resistant E. faecium bacteremia were compared with 30 control-patients with gastrointestinal colonization by vancomycin-resistant E. faecium. Patients with catheter-related vancomycin-resistant E. faecium bacteremia were more likely to have required mechanical ventilation (P < .01), received total parenteral nutrition (P < .01), and had polyurethane catheters (P < .01) inserted in the femoral vein (P = .01). With the use of pulsed-fleld gel electrophoresis, 4 of the 10 catheter-related vancomycin-resistant E. faecium bacteremia isolates were genetically indistinguishable, whereas only 2 of the 30 control vancomycin-resistant E. faecium isolates displayed this same DNA pattern (P = .03).

Conclusion:

This study suggests that catheter-related vancomycin-resistant E. faecium bacteremia occurs more frequently in patients who receive total parenteral nutrition, mechanical ventilation, and femoral catheters. (Infect Control Hosp Epidemiol 2005;26:658-661)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 7 , July 2005 , pp. 658 - 661
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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