Hypogammaglobulinemia and Poor Performance Status are Predisposing Factors for Vancomycin-Resistant Enterococcus Colonization in Patients with Hematological Malignancies

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dc.contributor.authorUmit, Elif Gulsum
dc.contributor.authorKuloglu, Figen
dc.contributor.authorDemir, Ahmet Muzaffer
dc.date.accessioned2024-06-12T11:03:36Z
dc.date.available2024-06-12T11:03:36Z
dc.date.issued2017
dc.departmentTrakya Üniversitesien_US
dc.description.abstractObjective: Vancomycin-resistant enterococci (VRE) are common pathogens of hospital-acquired infection. Long hospitalization periods, use of broadspectrum antibiotics, and immunosuppression are major risks for VRE colonization. We aimed to evaluate patients' characteristics and factors that may contribute to VRE colonization. Materials and Methods: Data of 66 patients with colonization and 112 patients without colonization who were hospitalized in the hematology clinic were collected. Hematological malignancies, preexisting gastrointestinal complaints, the presence of hypogammaglobulinemia at the time of diagnosis, complications like neutropenic enterocolitis (NEC), and Eastern Cooperative Oncology Group (ECOG) and Karnofsky performance statuses were recorded. Results: Ages of the patients ranged between 19 and 95 years (mean: 55.99). Karnofsky and ECOG scores were statistically related to VRE colonization (p<0.000 and p<0.000), though only the Karnofsky score was significant based on logistic regression analysis. Almost all patients with acute leukemia (45 patients) had been on antibiotics (piperacillin-tazobactam, ceftazidime, and meropenem), while no patients with myelodysplastic syndrome, myeloma, or benign diseases and 2 patients with lymphoma and 1 with chronic myeloid leukemia were on antibiotics. Median time for colonization regardless of antibiotic use and diagnosis was 4.5 days (range: 3-11 days). In the VRE-colonized group, 40.9% of patients had NEC development, while in the non-colonized group, only 1.7% had NEC development. In the VRE-colonized group 46 patients (69.7%) and in the non-colonized group 27 patients (24.1%) had hypogammaglobulinemia at diagnosis; among these patients, 23 patients in the VRE-colonized group (50%) had a B-cell malignancy (lymphoma, myeloma, or chronic lymphocytic leukemia). Conclusion: Besides already anticipated diseases like leukemia, B-cell malignancies are also at high risk for colonization. This proclivity may be attributed to lack of gastrointestinal IgA due to hypogammaglobulinemia. Prolonged hospitalization (>7 days) may also be accepted as a risk factor, independent of diagnosis or antibiotic use. Performance status is also an important factor for colonization, which may be related to poorer hygiene and increased external help.en_US
dc.identifier.doi10.4274/tjh.2016.0108
dc.identifier.endpage92en_US
dc.identifier.issn1300-7777
dc.identifier.issn1308-5263
dc.identifier.issue1en_US
dc.identifier.pmid27531123en_US
dc.identifier.scopus2-s2.0-85014478465en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage89en_US
dc.identifier.trdizinid283951en_US
dc.identifier.urihttps://doi.org/10.4274/tjh.2016.0108
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/283951
dc.identifier.urihttps://hdl.handle.net/20.500.14551/21718
dc.identifier.volume34en_US
dc.identifier.wosWOS:000398059500013en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherGalenos Yayinciliken_US
dc.relation.ispartofTurkish Journal Of Hematologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHypogammaglobulinemiaen_US
dc.subjectLeukemiaen_US
dc.subjectLymphomaen_US
dc.subjectMyelomaen_US
dc.subjectVancomycin-Resistant Enterococcusen_US
dc.subjectInfectionen_US
dc.titleHypogammaglobulinemia and Poor Performance Status are Predisposing Factors for Vancomycin-Resistant Enterococcus Colonization in Patients with Hematological Malignanciesen_US
dc.typeArticleen_US

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