Clinical relevance of vancomycin resistant enterococci carriage in stool of patients of hematologic malignancy undergoing intensive chemotherapy

Abstract

Bloodstream infections due to VRE constitute a major cause of morbidity and mortality in patients with hematologic malignancy and are usually preceded by colonization of the gastrointestinal tract. However, there are limited aggregate data concerning the prevalence of VRE colonization, associated risk factors, and the impact of colonization on subsequent VRE-related bloodstream infections in this patient population. In our analysis, 100 patients with hematological malignancies receiving intensive chemotherapy were enrolled in the study we found that 20% of patients with hematological malignancy were colonized with VRE and the prevalence was higher among patients with acute leukemia (about 75% of positive patients had acute leukemia). Positive nose or skin swab for MRSA may predict carriage of VRE in stool and may indicate the start of anti VRE during neutropenic fever. (Of the 20 positive patients 9 patients (45%) had positive nose swab for MRSA while 11 patients (55%) were negative. Of the 20 positive patients 8 patients (40%) had positive skin swab for MRSA, while 12 patients (60%) were negative.)