Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T23:45:21.368Z Has data issue: false hasContentIssue false
  • English
  • Français

Association Between Mucositis Severity and Vancomycin-Resistant Enterococcal Bloodstream Infection in Hospitalized Cancer Patients

Published online by Cambridge University Press:  02 January 2015

Matthew J. Kuehnert ,
John A. Jernigan ,
Amy L. Pullen ,
David Rimland  and
William R. Jarvis
Matthew J. Kuehnert*
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
John A. Jernigan
Affiliation:
Emory University School of Medicine, Atlanta, Georgia
Amy L. Pullen
Affiliation:
Emory University School of Medicine, Atlanta, Georgia
David Rimland
Affiliation:
Emory University School of Medicine, Atlanta, Georgia
William R. Jarvis
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Hospital Infections Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E69, Atlanta, GA 30333
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the role of mucositis severity in the development of vancomycin-resistant enterococcal (VRE) bloodstream infection (BSI).

Setting:

A tertiary-care university medical center.

Participants:

Hematology-oncology-unit inpatients.

Design:

Patients with VRE BSI (case-patients) were compared with VRE-colonized (control) patients from September 1994 through August 1997. Oral mucositis severity was recorded on the day of VRE BSI for case-patients and on hospital day 22 (median day of hospitalization of case-patient VRE BSI) for controls. There were 19 case-patients and 31 controls.

Results:

In univariate analysis, case-patients were significantly more likely than controls to have a higher mucositis severity score, diarrhea, or a higher severity of illness score. In multivariate analysis, only mucositis remained as an independent risk factor, and increasing mucositis score was significantly associated with VRE BSI.

Conclusions:

Mucositis severity was independently associated with an increasing risk for VRE BSI. Interventions to alter mucositis severity may help to prevent VRE BSI in hospitalized cancer patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 10 , October 1999 , pp. 660 - 663
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Murray, BE. The life and times of the Enterococcus . Clin Microbiol Rev 1990;3:4fr65.CrossRefGoogle ScholarPubMed
2. Spera, RV Jr, Farber, BF. Multiply-resistant Enterococcus faecium: the nosocomial pathogen of the 1990s. JAMA 1992;268:2563–2564.CrossRefGoogle ScholarPubMed
3. Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597–599.Google Scholar
4. Edmond, MB, Ober, JF, Dawson, JD, Weinbaum, DL, Wenzel, RP. Vancomycin-resistant enterococcal bacteremia: natural history and attributable mortality. Clin Infect Dis 1996;23:1234–1239.CrossRefGoogle ScholarPubMed
5. Shay, DK, Maloney, SA, Montecalvo, M, Banerjee, S, Wormser, GP, Arduino, MJ, et al. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis 1995;172:993–1000.CrossRefGoogle ScholarPubMed
6. Edmond, MB, Ober, JF, Weinbaum, DF, Pfaller, MA, Hwang, T, Sanford, MD, et al. Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis 1995;20:1126–1133.CrossRefGoogle ScholarPubMed
7. Montecalvo, MA, Shay, DK, Patel, P, Tacsa, L, Maloney, SA, Jarvis, WR, et al. Bloodstream infections with vancomycin-resistant enterococci. Arch Intern Med 1996;156:1458–1462.CrossRefGoogle ScholarPubMed
8. Elting, LS, Bodey, GP, Keefe, BH. Septicemia and shock syndrome due to viridans streptococci: a case-control study of predisposing factors. Clin Infect Dis 1992;15:33–48.Google Scholar
9. Bochud, P, Calandra, T, Francioli, P. Bacteremia due to viridans streptococci in neutropenic patients: a review. Am J Med 1994;97:256–264.CrossRefGoogle ScholarPubMed
10. Bochud, PY, Eggiman, P, Calandra, T, Van Melle, G, Saghafi, L, Francioli, P. Bacteremia due to viridans Streptococcus in neutropenic patients with cancer: clinical spectrum and risk factors. Clin Infect Dis 1994;18:25–31.CrossRefGoogle ScholarPubMed
11. Woo, SB, Sonis, ST, Monopoli, MM, Sonis, AL A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer 1993;72:1612–1617.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
12. Roghmann, MC, McCarter, RJ, Brewrink, J, Cross, AS, Morris, JG. Clostridium difficile infection is a risk factor for bacteremia due to VRE in VRE-colonized patients with acute leukemia. Clin Infect Dis 1997;25:1056–1059.CrossRefGoogle ScholarPubMed
13. Montecalvo, MA, Horowitz, H, Wormser, GP, Seiter, K, Carbonaro, CA. Effect of novobiocin-containing antimicrobial regimens on infection and colonization with vancomycin-resistant Enterococcus faecium . Antimicrob Agents Chemother 1995;39:794.CrossRefGoogle ScholarPubMed
14. Elmer, GW, Surawicz, CM, McFarland, LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–876.CrossRefGoogle ScholarPubMed
15. Jochimsen, EM, Fish, L, Manning, K, et al. Evaluation and control of vancomycin-resistant enterococci at an Indianapolis hospital. Seventh Annual Meeting of the Society for Healthcare Epidemiology of America, St Louis, MO, April 27-29, 1997. Abstract.Google Scholar