Vancomycin-resistant enterococcus (VRE) is an important cause of infection in immunocompromised populations. Few studies have described the characteristics of vanB VRE infection. We sought to describe the epidemiology, treatment and outcomes of VRE bloodstream infections (BSI) in a vanB predominant setting in malignant hematology and oncology patients. A retrospective review was performed at two large Australian centres and spanning a 6-year period (2008–2014). Evaluable outcomes were intensive care admission (ICU) within 48 h of BSI, all-cause mortality (7 and 30 days) and length of admission. Overall, 106 BSI episodes were observed in 96 patients, predominantly Enterococcus faecium vanB (105/106, 99%). Antibiotics were administered for a median of 17 days prior to BSI, and 76/96 (79%) were neutropenic at BSI onset. Of patients screened before BSI onset, 49/72 (68%) were found to be colonised. Treatment included teicoplanin (59), linezolid (6), daptomycin (2) and sequential/multiple agents (21). Mortality at 30-days was 31%. On multivariable analysis, teicoplanin was not associated with mortality at 30 days. VRE BSI in a vanB endemic setting occurred in the context of substantive prior antibiotic use and was associated with high 30-day mortality. Targeted screening identified 68% to be colonised prior to BSI. Teicoplanin therapy was not associated with poorer outcomes and warrants further study for vanB VRE BSI in cancer populations.

中文翻译：

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vanB地方性癌症患者因万古霉素耐药肠球菌引起的血流感染的流行病学，治疗和结局。

抗万古霉素肠球菌（VRE）是免疫功能低下人群感染的重要原因。很少有研究描述vanB VRE感染的特征。我们试图描述以vanB为主的恶性血液病和肿瘤患者的VRE血流感染（BSI）的流行病学，治疗和结局。回顾性审查在澳大利亚的两个大型中心进行，为期6年（2008-2014年）。可评估的结果是BSI 48小时内的重症监护病房（ICU），全因死亡率（7天和30天）和住院时间。总体而言，在96例患者中观察到106例BSI发作，主要是粪肠球菌vanB（105 / 106，99％）。在BSI发生之前，抗生素的中位数为17天，BSI发作时中性粒细胞减少为76/96（79％）。在BSI发作之前接受筛查的患者中，有49/72（68％）被定殖。治疗包括替考拉宁（59），利奈唑胺（6），达托霉素（2）和序贯/多种药物（21）。30天死亡率为31％。在多变量分析中，替考拉宁与30天时的死亡率无关。vanB流行环境中的VRE BSI发生在先前大量使用抗生素的情况下，并与30天高死亡率相关。靶向筛查确定68％的人在BSI之前定植。Teicoplanin治疗与较差的预后无关，需要对癌症人群中的vanB VRE BSI进行进一步研究。替考拉宁在30天时与死亡率无关。vanB流行环境中的VRE BSI发生在先前大量使用抗生素的情况下，并与30天高死亡率相关。靶向筛查确定68％的人在BSI之前定植。Teicoplanin治疗与较差的预后无关，需要对癌症人群中的vanB VRE BSI进行进一步研究。替考拉宁在30天时与死亡率无关。vanB流行环境中的VRE BSI发生在先前大量使用抗生素的情况下，并与30天高死亡率相关。靶向筛查确定68％的人在BSI之前定植。Teicoplanin治疗与较差的预后无关，需要对癌症人群中的vanB VRE BSI进行进一步研究。