{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:53:12Z","timestamp":1787982792974,"version":"build-2784847793"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2012,6,15]],"date-time":"2012-06-15T00:00:00Z","timestamp":1339718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Cubist Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background.<\/jats:title>\n                  <jats:p>Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) can cause significant morbidity and mortality in patients with cancer. However, data on outcomes of patients treated with vancomycin are lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>We identified 223 patients with cancer who developed MRSA BSIs between January 2001 and June 2009 and were treated with vancomycin. Treatment failure was defined as death within 60 days of infection, persistent bacteremia \u22655 days, fever \u22654 days, recurrence or relapse, and secondary MRSA infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>The treatment failure rate was 52% (116 of 223 patients). These patients were more likely to have been hospitalized, been treated with steroids within the previous 3 months, developed acute respiratory distress syndrome, required mechanical ventilation, required intensive care unit care, and community-onset infections (all p &amp;lt; .05). Risk factors for MRSA-associated mortality (27 of 223 patients; 12%) included hematologic malignancy and hematopoietic stem cell transplantation, community-onset infection, secondary BSI, MRSA with minimum inhibitory concentration (MIC) \u22652.0 \u03bcg\/mL, mechanical ventilation, and a late switch to an alternative therapy (\u22654 days after treatment failure; all p &amp;lt; .05). On multivariate analysis, mechanical ventilation and recent hospitalization were identified as independent predictors of vancomycin failure, and community-onset infection, secondary BSIs, and MIC \u22652 \u03bcg\/mL were identified as significant predictors of MRSA-associated mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>We found a high treatment failure rate for vancomycin in patients with cancer and MRSA BSIs, as well as a higher mortality. A vancomycin MIC \u22652 \u03bcg\/mL was an independent predictor of MRSA-associated mortality. An early switch to an alternative therapy at the earliest sign of failure may improve outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2012-0029","type":"journal-article","created":{"date-parts":[[2012,6,17]],"date-time":"2012-06-17T21:40:09Z","timestamp":1339969209000},"page":"1329-1336","source":"Crossref","is-referenced-by-count":47,"title":["Characteristics and Outcomes of Methicillin-Resistant <i>Staphylococcus aureus<\/i> Bloodstream Infections in Patients with Cancer Treated with Vancomycin: 9-Year Experience at a Comprehensive Cancer Center"],"prefix":"10.1093","volume":"17","author":[{"given":"Sminil N.","family":"Mahajan","sequence":"first","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jharna N.","family":"Shah","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Hachem","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tverdek","sequence":"additional","affiliation":[{"name":"b Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier A.","family":"Adachi","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Mulanovich","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth V.","family":"Rolston","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam I.","family":"Raad","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy F.","family":"Chemaly","sequence":"additional","affiliation":[{"name":"a Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,6,15]]},"reference":[{"key":"2021122308130953300_B1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/clinids\/23.2.255","article-title":"Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: Impact of intravascular devices and methicillin resistance","volume":"23","author":"Steinberg","year":"1996","journal-title":"Clin Infect Dis"},{"key":"2021122308130953300_B2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1086\/313650","article-title":"Pathogenic significance of methicillin resistance for patients with Staphylococcus aureus bacteremia","volume":"30","author":"Soriano","year":"2000","journal-title":"Clin Infect Dis"},{"key":"2021122308130953300_B3","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/S0196-6553(96)90026-7","article-title":"National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. 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