Empiric use of linezolid in febrile hematology and hematopoietic stem cell transplantation patients colonized with vancomycin-resistant Enterococcus spp
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Citações na Scopus
29
Tipo de produção
article
Data de publicação
2015
Editora
ELSEVIER SCI LTD
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Título da Revista
ISSN da Revista
Título do Volume
Autores
LISBOA, Luiz F.
MIRANDA, Bianca G.
FONSECA, Guilherme G.
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Citação
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.33, p.171-176, 2015
Resumo
Objectives: We conducted a retrospective study on the impact of the empiric use of linezolid on mortality in vancomycin-resistant Enterococcus spp (VRE)-colonized hematology and hematopoietic stem cell transplantation (HSCT) patients. Methods: VRE-colonized inpatients for whom complete data were available (n = 100) were divided into two groups: those who received empiric linezolid in the course of fever refractory to broad-spectrum antibiotics, replacing the glycopeptide utilized for the previous 48 h, and those who did not (control group). All patients were followed until hospital discharge or death. The impact of linezolid and risk factors for all-cause mortality were evaluated; variables with p < 0.10 were analyzed in a multivariate model. A Kaplan-Meier survival analysis was done to compare survival among febrile patients colonized by VRE who received empiric linezolid with patients who did not receive linezolid. Results: Patients empirically prescribed linezolid were generally younger (median age 33 vs. 44 years; p = 0.008) and more likely to be recipients of an allogeneic HSCT (24 (68.6%) vs. 24 (36.9%); p = 0.009) than patients who did not receive the drug. Fourteen (21.5%) VRE bloodstream infections were diagnosed, all in patients who did not receive empiric linezolid (p = 0.002). In-hospital mortality was comparable in empiric linezolid and non-linezolid users (19 (54.3%) vs. 27 (41.5%), respectively; p = 0.293). The Kaplan-Meier survival analysis showed no significant difference in survival comparing the group that received linezolid to the group that did not (p = 0.72). Graft-versus-host disease (GVHD; odds ratio (OR) 5.90, 95% confidence interval (CI) 1.46-23.79; p = 0.012) and persistence of neutropenia (OR 6.93, 95% CI 1.72-27.94; p = 0.0065) were independent predictors of all-cause in-hospital death in HSCT patients, and persistence of neutropenia in non-HSCT patients (OR 8.12, 95% CI 1.22-53.8; p = 0.030). Conclusions: The empiric use of linezolid in VRE-colonized hematology patients had no impact on mortality, which appeared rather to be associated with the persistence of neutropenia in general and GVHD in the HSCT group. (C) 2015 The Authors.
Palavras-chave
Linezolid, VRE, Hematology, Bone marrow transplant
Referências
- Avery R, 2005, BONE MARROW TRANSPL, V35, P497, DOI 10.1038/sj.bmt.1704821
- Bach PB, 2002, INFECT CONT HOSP EP, V23, P471, DOI 10.1086/502089
- Bossaer JB, 2011, SUPPORT CARE CANCER, V19, P231, DOI 10.1007/s00520-009-0808-y
- Brandl K, 2008, NATURE, V455, P804, DOI 10.1038/nature07250
- Cohen N, 2009, BIOL BLOOD MARROW TR, V15, P1337, DOI 10.1016/j.bbmt.2009.05.021
- Demiraslan H, 2013, INT J HEMATOL, V97, P414, DOI 10.1007/s12185-013-1296-x
- DiazGranados CA, 2005, J INFECT DIS, V191, P588, DOI 10.1086/427512
- DiazGranados CA, 2005, CLIN INFECT DIS, V41, P327, DOI 10.1086/430909
- Dibo I, 2004, J CLIN MICROBIOL, V42, P1843, DOI 10.1128/JCM.42.4.1843-1845.2004
- Dubberke ER, 2006, BONE MARROW TRANSPL, V38, P813, DOI 10.1038/sj.bmt.1705530
- Fossati M, 2010, J MED MICROBIOL, V59, P839, DOI 10.1099/jmm.0.018598-0
- Freifeld AG, 2011, CLIN INFECT DIS, V52, pE56, DOI 10.1093/cid/cir073
- GARNER JS, 1988, AM J INFECT CONTROL, V16, P128, DOI 10.1016/0196-6553(88)90053-3
- Ghanem G, 2007, INFECT CONT HOSP EP, V28, P1054, DOI 10.1086/519932
- Hogan Holly L, 2010, J Pharm Pract, V23, P352, DOI 10.1177/0897190009358773
- Hughes WT, 1997, CLIN INFECT DIS, V25, P551, DOI 10.1086/513764
- Irfan S, 2008, BMC INFECT DIS, V8, DOI 10.1186/1471-2334-8-80
- Kamboj M, 2010, BIOL BLOOD MARROW TR, V16, P1576, DOI 10.1016/j.bbmt.2010.05.008
- Kinnebrew MA, 2010, J INFECT DIS, V201, P534, DOI 10.1086/650203
- Klastersky J, 2000, J CLIN ONCOL, V18, P3038
- Kraft S, 2011, SUPPORT CARE CANCER, V19, P1969, DOI 10.1007/s00520-010-1038-z
- Liss BJ, 2012, INFECTION, V40, P613, DOI 10.1007/s15010-012-0269-y
- Matar MJ, 2006, AM J INFECT CONTROL, V34, P534, DOI 10.1016/j.ajic.2006.04.205
- McKinnell JA, 2011, EPIDEMIOL INFECT, V139, P1342, DOI 10.1017/S0950268810002475
- Miyazaki S, 2001, J MED MICROBIOL, V50, P695
- Olivier CN, 2008, INFECT CONT HOSP EP, V29, P404, DOI 10.1086/587647
- Richters A, 2014, BONE MARROW TRANSPL, V49, P264, DOI 10.1038/bmt.2013.172
- Rolston KVI, 2007, BONE MARROW TRANSPL, V39, P567, DOI 10.1038/sj.bmt.1705639
- Sader H S, 2009, J Chemother, V21, P611
- Scheetz MH, 2008, ANTIMICROB AGENTS CH, V52, P2256, DOI 10.1128/AAC.00070-08
- Suppli M, 2011, CLIN MICROBIOL INFEC, V17, P1078, DOI 10.1111/j.1469-0691.2010.03394.x
- Taur Y, 2012, CLIN INFECT DIS, V55, P905, DOI 10.1093/cid/cis580
- Todeschini G, 2006, J INFECTION, V53, P266, DOI 10.1016/j.jinf.2005.11.012
- Ubeda C, 2010, J CLIN INVEST, V120, P4332, DOI 10.1172/JCI43918
- Vydra J, 2012, CLIN INFECT DIS, V55, P764, DOI 10.1093/cid/cis550
- Weinstock DM, 2007, BIOL BLOOD MARROW TR, V13, P615, DOI 10.1016/j.bbmt.2007.01.078
- Zhao CJ, 2012, DIAGN MICR INFEC DIS, V73, P174, DOI 10.1016/j.diagmicrobio.2012.03.003