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Leuk Lymphoma ; 58(11): 2565-2572, 2017 11.
Article in English | MEDLINE | ID: mdl-28351179

ABSTRACT

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.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Gram-Positive Bacterial Infections/drug therapy , Leukemia, Myeloid/drug therapy , Myelodysplastic Syndromes/drug therapy , Vancomycin-Resistant Enterococci/drug effects , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Cephalosporins/therapeutic use , Cytarabine/administration & dosage , Female , Gram-Positive Bacterial Infections/complications , Gram-Positive Bacterial Infections/microbiology , Humans , Idarubicin/administration & dosage , Induction Chemotherapy , Leukemia, Myeloid/complications , Male , Middle Aged , Multivariate Analysis , Myelodysplastic Syndromes/complications , Retrospective Studies , Risk Factors , Vancomycin/pharmacology , Vancomycin/therapeutic use , Vancomycin-Resistant Enterococci/isolation & purification , Young Adult
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