K-1407. Impact of Vancomycin-Resistant Enterococci Acquisition on the Prognosis Among Patients with Cancer
Session: Poster Session: Infections in BMT, Cancer and Neutropenic Patients
Sunday, October 26, 2008: 12:00 AM
Room: Hall C
Background: Vancomycin-resistant enterococci(VRE) have emerged as important nosocomial pathogens. Risk for VRE acquisition is high in cancer patients and organ transplant recipients. However, a major impact on the prognosis of cancer patients with VRE acquisition is hardly known. We evaluated risk factors for prognosis among patients with cancer who were colonized or infected with VRE.
Methods: We evaluated clinical manifestations, incidence and risk factors for newly developed infection and mortality in 209 cancer patients with VRE acquisition at a 2000 bed university hospital from 2005 to 2007. In addition, a case control study was performed to investigate development of VRE BSI. 15 cancer patients with VRE BSI were compared with control patients (n=45) matched by sex, admission unit, age (±5 year), type of malignancy and disease stage.
Results: 209 patients were analyzed and the incidence of newly developed infection after VRE acquisition was 67cases (32.3%). According to univariate analysis, significant risk factors for infection were : hospital days before VRE acquisition of ≥14days, glycopeptides use before VRE acquisition for ≥7days and acute renal failure (ARF) at the time of VRE acquisition. No predictors were identified in the multivariate analysis. According to univariate and multivariate analyses of risk factors for mortality,six variables remained significant risk factors: new infection (p=0.023), VRE BSI after colonization (p=0.022), presence of shock (p<0.01), ARF (p<0.01) and history of invasive procedure : foley catheter insertion (p=0.036), chest tube insertion (p<0.01). Shock at the time of VRE acquisition was an independent predictive factor for VRE BSI after VRE colonization (relative risk,9.36, 95%confidence interval,1.50-58.29,p<0.01).
Conclusions: On the basis of our findings, it seems mandatory to closely observe cancer patients after VRE acquisition with factors mentioned above.
Hee Kyung Choi, MD1, Jun Yong Choi, staff2, June Myung Kim, MD3, Sang Hoon Han, MD3, Su Jin Jeong, MD3, Young Goo Song, MD4, Bum Sik Chin, MD5, Chang Oh Kim, Fellow2, Han Sung Lee6 and  S. Jeong, None., (1)Yonsei university college of medicine, Seoul, Korea, Republic of, (2)Yonsei University College of Medicine, Seoul, Korea, Republic of, (3)AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea, (4)Yonsei Univ. Coll. of Med., Seoul, Korea, Republic of, (5)Yonsei University Medical Center, Seoul, Korea, Republic of, (6)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine