Relationship of Colonization with Vancomycin-Resistant Enterococci and Risk of Systemic Infection in Patients with Cancer

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Abstract
TotheEditor—We read with great interest the article by McNeil et al. [1] regarding vancomycin-resistant enterococci (VRE) colonization and infection in patients undergoing liver transplantation. These organisms are also significant pathogens in patients with an underlying malignancy, accounting for substantial morbidity and mortality among this population [2]. We have conducted a similar study involving patients with hematological malignancies and hematopoietic stem cell transplant (HSCT) recipients at our institution, a National Cancer Institute—designated comprehensive cancer center. For such patients, 3 weekly rectal swab samples are routinely obtained to detect fecal colonization with VRE, while maintaining contact isolation [3]. We collected data on fecal colonization with VRE and subsequent infections over a 1-year period in hospitalized patients with leukemia, lymphoma, and receipt of HSCT. We describe our findings below.