{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:36:02Z","timestamp":1786703762560,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Johann Wolfgang Goethe-Universit\u00e4t, Frankfurt am Main"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Vancomycin-resistant enterococci (VRE) colonization is common among patients with acute myeloid leukemia (AML) undergoing intensive chemotherapy. Whether the teicoplanin-defined VRE phenotype, specifically\n vanA-<\/jats:italic>\n consistent (teicoplanin-resistant) versus\n vanB<\/jats:italic>\n -consistent (teicoplanin-susceptible), is associated with adverse outcomes is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a retrospective single-center cohort study of 192 VRE-colonized AML patients who received intensive induction chemotherapy between 2015 and 2024.\n vanA-<\/jats:italic>\n consistent phenotype (\n n<\/jats:italic>\n \u2009=\u200935, 18.2%) was defined as VRE isolates demonstrating vancomycin (MIC\u2009>\u20094\u00a0mg\/l) and teicoplanin resistance (MIC\u2009>\u20092\u00a0mg\/L).\n vanB<\/jats:italic>\n -consistent phenotype (\n n<\/jats:italic>\n \u2009=\u2009157, 81.8%) was defined as VRE isolates susceptible to teicoplanin. The primary endpoint was overall survival (OS). Cox proportional hazards regression estimated the association between VRE phenotype and OS with adjustment for ELN 2022 genetic risk, sex, ECOG performance status, and allogeneic stem cell transplantation. Healthcare-exposure variables were compared between phenotypes, and the interaction between\n vanA<\/jats:italic>\n -consistent phenotype and cumulative inpatient days before VRE detection was evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Results\u00a0<\/jats:title>\n \n vanA<\/jats:italic>\n -consistent phenotype patients had significantly inferior OS compared with\n vanB<\/jats:italic>\n -consistent phenotype patients (3-year OS 46.1% vs. 73.2%; log-rank\n p<\/jats:italic>\n \u2009=\u20090.004).\n vanA-<\/jats:italic>\n consistent phenotype was strongly associated with adverse-risk ELN 2022 genetics (54% vs. 24%; OR 3.69,\n p<\/jats:italic>\n \u2009<\u20090.001). Despite this association,\n vanA<\/jats:italic>\n -consistent phenotype remained associated with OS after adjustment for ELN 2022 risk, sex, ECOG, and allo-SCT (HR 1.85, 95% CI 1.03\u20133.34,\n p<\/jats:italic>\n \u2009=\u20090.041). The\n vanA<\/jats:italic>\n -associated hazard increased with longer cumulative inpatient exposure before VRE detection. No significant differences were observed for infection-related complications between\n vanA-<\/jats:italic>\n and\n vanB-<\/jats:italic>\n consistent phenotypes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions\u00a0<\/jats:title>\n \n vanA<\/jats:italic>\n -consistent phenotype VRE colonization is an adverse prognostic factor in VRE-colonized AML patients, providing prognostic information beyond ELN 2022 genetic risk classification. To our knowledge, this is the first study to demonstrate differential outcomes by teicoplanin-defined VRE phenotype. Despite enrichment for adverse-risk genetics in\n vanA<\/jats:italic>\n -consistent phenotype patients, this did not fully account for the survival disadvantage. Prospective multicenter validation is warranted.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s15010-026-02836-5","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:35:29Z","timestamp":1779953729000},"page":"2075-2084","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["vanA-consistent phenotype vancomycin-resistant enterococcal colonization is associated with inferior overall survival in acute myeloid leukemia patients undergoing intensive chemotherapy: a single-center retrospective study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9993-9750","authenticated-orcid":false,"given":"Sebastian","family":"Wolf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Zeltner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Henze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius C.","family":"Enssle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkhard A. J.","family":"Kempf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Kessel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.G.T.","family":"Vehreschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Steffen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Oellerich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Serve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hogardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Scheich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"2836_CR1","doi-asserted-by":"publisher","DOI":"10.1182\/BLOOD.2022016867","author":"H D\u00f6hner","year":"2022","unstructured":"D\u00f6hner H, Wei AH, Appelbaum FR, Craddock C, DiNardo CD, Dombret H, et al. Diagnosis and Management of AML in Adults: 2022 ELN Recommendations from an International Expert Panel. Blood [Internet] Blood. 2022. https:\/\/doi.org\/10.1182\/BLOOD.2022016867. [cited 2022 Aug 11].","journal-title":"Blood [Internet] Blood"},{"key":"2836_CR2","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1200\/JCO.2017.77.6211","volume":"36","author":"RA Taplitz","year":"2018","unstructured":"Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK, et al. Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update. 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Consulting fees were received from GILEAD, Tillotts, Pfizer, Bioaster, GSK, Ecraid, EUMEDICA, Bactolife, and PAION (payments made to the author personally). Honoraria for lectures, presentations, or educational activities (payments made to the author personally): Akademisches Forum Augsburg, Akademie f\u00fcr Infektionsmedizin, AstraZeneca, bioM\u00e9rieux, Biotest, DGI, European Society of Neurogastroenterology, Falk Foundation, FomF GmbH, GFO Kliniken Bonn, GILEAD, GSK, Helios Kliniken, Hessisches Landessozialgericht, Infektio Forum, Janssen-Cilag GmbH, Klinik Bavaria Kreischa, Klinikum Kassel, Klinikverbund St. Antonius & St. Josef GmbH, Landes\u00e4rztekammer Hessen, LMU Kliniken, MRE Netzwerk F\u00f6rderverein, MSD, Pfizer, Shionogi, Streamed Up, St. Vincent Hospital, Tillotts, and Vivantes.\u00a0All other authors declare no competing interests related to this work.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the institutional ethics committee of Goethe University Frankfurt (approval number: SHN-08-2017).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}