OVERGROWTH OF ENTEROCOCCUS-FAECIUM IN THE FECES OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES

The objective of this study was to characterize the overgrowth and sus ceptibility of Enterococcus faecium, compared with that of other enter ococci, in the feces of patients with hematologic malignancy, During a 52-week period, surveillance samples of feces were cultured weekly, T hree hundred thirty-three samples were obtained from 92 patients. E. f aecium outnumbered other enterococci in 170 (44%) of the samples, whil e the opposite was true in 119 (31%) of the samples, Fecal overgrowth of E. faecium (greater than or equal to 9.0 log(10) cfu/g) was found i n 62 samples (16%), while overgrowth of other enterococci was document ed in 20 samples (5%) (P < .001), Treatment with third-generation ceph alosporins preceded the overgrowth of E. faecium in 93% of the patient s, Resistance of E. faecium isolates to ampicillin, high-level gentami cin, and vancomycin was detected in 41%, 4%, and 2% of the patients, r espectively. There were 6 patients with enterococcal bacteremia (due t o E. faecium in 5 and Enterococcus faecalis in 1) during the study per iod, The high prevalence of resistance to ampicillin and imipenem rend ered few (if any) intravenous antibiotics able to prevent fecal overgr owth of E. faecium.