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Annals of Hematology

, Volume 98, Issue 3, pp 763–773 | Cite as

Bloodstream infections with vancomycin-resistant enterococci are associated with a decreased survival in patients with hematological diseases

  • Sarah WeberEmail author
  • Michael Hogardt
  • Claudia Reinheimer
  • Thomas A. Wichelhaus
  • Volkhard A. J. Kempf
  • Johanna Kessel
  • Sebastian Wolf
  • Hubert Serve
  • Björn Steffen
  • Sebastian Scheich
Original Article
  • 190 Downloads

Abstract

Enterococcus species are commensals of the human gastrointestinal tract with the ability to cause invasive infections. For patients with hematological diseases, enterococcal bloodstream infections (BSI) constitute a serious clinical complication which may even be aggravated if the pathogen is vancomycin-resistant. Therefore, we analyzed the course of BSI due to vancomycin-susceptible enterococci (VSE) in comparison to vancomycin-resistant enterococci (VRE) on patient survival. In this retrospective single-center study, BSI were caused by VRE in 47 patients and by VSE in 43 patients. Baseline patient characteristics were similar in both groups. Concerning infection-related characteristics, an increased CRP value and an increased rate of prior colonization with multidrug-resistant organisms were detected in the VRE BSI group. More enterococcal invasive infections were found in the VSE group. The primary endpoint, overall survival (OS) at 30 days after BSI, was significantly lower in patients with VRE BSI compared to patients with VSE BSI (74.5% vs. 90.7%, p = 0.039). In a multivariate regression analysis, VRE BSI and a Charlson comorbidity index higher than 4 were independent factors associated with 30-day mortality. Moreover, we found that VRE with an additional teicoplanin resistance showed a trend towards an even lower OS.

Keywords

Bloodstream infections Hematological diseases Multidrug-resistant organisms Vancomycin-resistant enterococci Survival 

Notes

Acknowledgments

The authors thank all the physicians, nurses, technicians, and other hospital staff involved in patient care and lab work.

Compliance with ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

277_2019_3607_MOESM1_ESM.docx (18 kb)
Table S1 (DOCX 17 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sarah Weber
    • 1
    • 2
    Email author
  • Michael Hogardt
    • 2
    • 3
    • 4
  • Claudia Reinheimer
    • 2
    • 3
    • 4
  • Thomas A. Wichelhaus
    • 2
    • 3
    • 4
  • Volkhard A. J. Kempf
    • 2
    • 3
    • 4
  • Johanna Kessel
    • 2
    • 5
  • Sebastian Wolf
    • 1
    • 2
  • Hubert Serve
    • 1
    • 2
  • Björn Steffen
    • 1
    • 2
  • Sebastian Scheich
    • 1
    • 2
  1. 1.Department of Hematology and OncologyUniversity Hospital FrankfurtFrankfurt am MainGermany
  2. 2.University Center for Infectious Diseases (UCI), University Hospital FrankfurtFrankfurt am MainGermany
  3. 3.Institute of Medical Microbiology and Infection ControlUniversity Hospital FrankfurtFrankfurt am MainGermany
  4. 4.University Center of Competence for Infection Control, University Hospital FrankfurtFrankfurt am MainGermany
  5. 5.Department of Medicine, Infectious Diseases UnitUniversity Hospital FrankfurtFrankfurt am MainGermany

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