Innovative Analysis of the Sequenced Patterns of Vancomycin-ResistantEnterococciStrains to Determine Clonal Transmission in a Hospital Setting

2015 ◽  
Vol 36 (12) ◽  
pp. 1461-1463 ◽  
Author(s):  
Roy F. Chemaly ◽  
Shashank S. Ghantoji ◽  
Thomas Huber ◽  
Issam I. Raad ◽  
Chetan Jinadatha ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Hospital Setting ◽  
Infect Control Hosp ◽  
Cancer Center ◽  
Cell Transplant ◽  
Service Unit ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Isolates from patients who acquired vancomycin-resistant enterococci (VRE) were examined for the frequency of genetically indistinguishable strains on leukemia and stem cell transplant units at a major cancer center for 1 year. A total of 14 strains recurred, primarily on the same floor and in the same service unit an average of 49 days apart.Infect. Control Hosp. Epidemiol.2015;36(12):1461–1463

Epidemiology of Vancomycin-Resistant Enterococci Among Patients on an Adult Stem Cell Transplant Unit: Observations From an Active Surveillance Program

2008 ◽  
Vol 29 (11) ◽  
pp. 1019-1025 ◽  
Author(s):  
Michael S. Calderwood ◽  
Andreas Mauer ◽  
Jocelyn Tolentino ◽  
Ernesto Flores ◽  
Koen van Besien ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Stem Cell ◽  
Active Surveillance ◽  
Stem Cell Transplant ◽  
Surveillance Program ◽  
Cell Transplant ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Active Surveillance Program

Objective.To use the findings of an active surveillance program to delineate the unique epidemiology of vancomycin-resistant enterococci (VRE) in a mixed population of transplant and nontransplant patients hospitalized on a single patient care unit.Design.Surveillance survey and case-control analysis.Setting.A 19-bed adult bone marrow and stem cell transplant unit at a referral and primary-care center.Patients.The study included patients undergoing transplantation, patients who had previously received bone marrow or stem cell transplants, and patients with other malignancies and hematological disorders who were admitted to the study unit.Methods.Patients not previously identified as colonized with VRE had perirectal swab specimens collected at admission and once weekly while hospitalized on the unit. The prevalence of VRE colonization at admission and the incidence throughout the hospital stay, genotypes of VRE specimens as determined by pulsed field gel electrophoresis, and risk factors related to colonization were analyzed.Results.There was no significant difference in the prevalence or incidence of new colonization between nontransplant patients and prior or current transplant recipients, although overall prevalence at admission was significantly higher in the prior transplant group. Preliminary genotypic analysis of VRE isolates from transplant patients suggests that a proportion of cases of newly detected VRE carriage may represent prior colonization not detected at admission, with different risk factors suggestive of a potential epidemiological distinction.Conclusion.Examination of epidemiological and microbiological data collected by an active surveillance program provides useful information about the epidemiology of VRE that can be applied to inform rational infection control strategies.

scholarly journals End-of-life care for older AML patients relapsing after allogeneic stem cell transplant at a dedicated cancer center

2018 ◽  
Vol 54 (5) ◽  
pp. 700-706 ◽  
Author(s):  
Richard J. Lin ◽  
Theresa A. Elko ◽  
Miguel-Angel Perales ◽  
Koshy Alexander ◽  
Ann A. Jakubowski ◽  
...  
Keyword(s):  
Stem Cell ◽  
End Of Life ◽  
End Of Life Care ◽  
Stem Cell Transplant ◽  
Cancer Center ◽  
Cell Transplant ◽  
Life Care ◽  
Allogeneic Stem Cell Transplant

scholarly journals 1235. Transmission of Genetically Related, Multidrug Resistant, and Invasive Vancomycin-Resistant Enterococci (VRE) Between Patients and Rooms on the Stem Cell Transplant (SCT) and Leukemia (LKM) Units

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S375-S375
Author(s):  
Lynn El Haddad ◽  
Blake Hanson ◽  
Cesar Arias ◽  
Glen Otero ◽  
Cynthia Harb ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Phylogenetic Analyses ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Genetic Lineage ◽  
Cell Transplant ◽  
Research Support ◽  
Genetic Lineages ◽  
Sequence Types

Abstract Background VRE are a major cause of morbidity and mortality in immunocompromised patients. Tracking the dissemination of VRE strains is crucial to understand the dynamics of infections, emergence, and spread of VRE in the hospital setting. Methods Whole-genome sequencing (WGS) and phylogenetic analyses were performed to identify dominant VRE strains and potential transmission networks between patients and their rooms on the leukemia (LKM) and the stem cell transplant (SCT) units, located on two consecutive floors. We included 35 VRE-positive rectal swabs from SCT and LKM patients, and 55 environmental swabs from the patients’ main rooms and bathrooms. Sequence types, drug resistance genes, virulence genes, and patients’ outcomes were also determined. Results We identified VRE strains with newly described sequence types (ST) such as ST736, ST494, and ST772 which were isolated from both floors. One VRE genetic lineage belonged to ST494 (only previously isolated in Peru and was the only VanB-type strain). All other strains harbored the vanA gene. We observed highly genetically related strains transmitted between distinct rooms, floors, and time periods within the hospital in a period of 1 month (figure). Of five VRE bacteremia events, three strains were lacking the pili operon fms14-17-13 (ST203) and the remaining two were resistant to daptomycin (ST736, ST664) (figure). Of 10 patients harboring daptomycin-resistant strains, only 3 (30%) were exposed to daptomycin within 18 months before strain recovery. Conclusion Our findings confirmed horizontal transfer of highly related genetic lineages of multidrug resistant and invasive VRE strains between SCT and LKM patients and their room environment. New STs were identified and some correlated with bacteremia events. The use of a routine real-time WGS can characterize VRE strains and identify potential reservoirs of transmission in the healthcare setting in order to design interventions to prevent and control the spread of opportunistic and highly resistant organisms. Disclosures C. Arias, Merck & Co., Inc.: Grant Investigator, Research support. MeMed: Grant Investigator, Research support. Allergan: Grant Investigator, Research support. M. Stibich, Xenex Services: Employee, Salary. R. F. Chemaly, Xenex Services: Consultant and Grant Investigator, Research grant.

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