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Efficacy of percutaneous abscess drainage in patients with vancomycin-resistant enterococci
O A Catalano1, P F Hahn, D C Hooper
1Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
Objective:
We reviewed a 4-year experience draining fluid collections infected with vancomycin-resistant enterococci to determine the outcome of percutaneous intervention in patients with this highly resistant and increasingly common organism.
Materials And Methods:
Charts of patients from whom vancomycin-resistant enterococci had been isolated during percutaneous drainage were reviewed to determine patient response to drainage, catheter management, and outcome of treatment.
Results:
Twenty-one patients underwent percutaneous drainage of 28 fluid collections from which vancomycin-resistant enterococci were isolated, including 16 intraabdominal abscesses, seven biliary or urinary obstructions, and five empyemas. The drainage of 27 (96%) of 28 collections were technically successful. In seven patients, drainage provided the first isolation of vancomycin-resistant enterococci from the patient. Five patients also had blood cultures with positive findings for vancomycin-resistant enterococci, and 14 collections were coinfected with other bacteria or with fungi. Twenty collections (71%) or obstructions were successfully treated with percutaneous drainage. Drainage was unsuccessful in treating eight collections in seven patients.
Conclusion:
Despite high-level antibiotic resistance, fluid collections infected with vancomycin-resistant enterococci can be successfully drained percutaneously, resulting in a favorable likelihood of recovery for patients.
Insights
Percutaneous drainage of fluid collections infected with vancomycin-resistant enterococci (VRE) is effective. This minimally invasive approach offers a favorable outcome for patients with VRE infections.
Area of Science:
- Infectious Diseases
- Interventional Radiology
- Microbiology
Background:
- Vancomycin-resistant enterococci (VRE) are a significant cause of healthcare-associated infections.
- Fluid collections infected with VRE present a therapeutic challenge due to high-level antibiotic resistance.
Purpose of the Study:
- To evaluate the efficacy and outcomes of percutaneous intervention for draining fluid collections infected with vancomycin-resistant enterococci.
- To assess the success rate of percutaneous drainage in managing VRE-infected collections.
Main Methods:
- Retrospective review of patient charts over a 4-year period.
- Analysis of percutaneous drainage procedures for fluid collections yielding vancomycin-resistant enterococci.
- Evaluation of patient response, catheter management, and treatment outcomes.
Main Results:
- Twenty-eight fluid collections in 21 patients were drained percutaneously, with technical success in 96% of cases.
- Twenty collections (71%) were successfully treated with percutaneous drainage.
- VRE was initially isolated from seven patients during drainage; five had concurrent bacteremia.
Conclusions:
- Percutaneous drainage is a viable and effective treatment for fluid collections infected with vancomycin-resistant enterococci.
- Despite high antibiotic resistance, percutaneous intervention can lead to favorable patient recovery.