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We describe an outbreak of vancomycin-resistant Enterococcus faecium (vanA phenotype) bacteremia on the oncology ward of a tertiary care community hospital. In 10 of the 11 cases the patients had leukemia and were neutropenic (median duration of neutropenia, 21 days) at the time of bacteremia. On average, patients received six antibiotic agents for a total of 61 agent-days prior to development of vancomycin-resistant E. faecium bacteremia. The mortality rate was 73%. Molecular typing of 22 isolates revealed that the majority (83%) represented a common strain, indicating nosocomial spread. When the 11 cases were compared to 22 matched control patients, gastrointestinal colonization with vancomycin-resistant E. faecium (odds ratio [denominator, 0] infinity, P = .005) and the use of antimicrobial agents with significant activity against anaerobes (metronidazole, clindamycin, and imipenem; odds ratio infinity, P = .02) were found to be risk factors for the development of vancomycin-resistant E. faecium bacteremia. Since no proven therapy for such infection exists, there is an urgent need to identify effective measures to prevent and control the development of vancomycin-resistant E. faecium bacteremia.
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
January 2001,
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
September 2007,
Infection control and hospital epidemiology,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
March 2022,
Microbial drug resistance (Larchmont, N.Y.),
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
January 2006,
Scandinavian journal of infectious diseases,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
June 2000,
Revista medica de Chile,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
April 1996,
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
August 2001,
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
July 2005,
Infection control and hospital epidemiology,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
June 2007,
Medicina clinica,
M B Edmond, and
J F Ober, and
D L Weinbaum, and
M A Pfaller, and
T Hwang, and
M D Sanford, and
R P Wenzel
December 2018,
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi,
