Intraabdominal vancomycin-resistant enterococcus infections: the new threat

Area of Science:

• Infectious Diseases
• Surgical Infections
• Nosocomial Pathogens

Background:

• Vancomycin-resistant enterococcus (VRE) is a significant and increasing nosocomial pathogen.
• VRE incidence is particularly rising in the context of abdominal surgery.
• Intraabdominal VRE infections (VRE-A) represent a serious clinical challenge.

Purpose of the Study:

• To investigate the clinical course and outcomes of patients with intraabdominal VRE infections (VRE-A).
• To identify potential risk factors associated with VRE-A.
• To compare VRE-A with VRE infections in other sites (VRE-O).

Main Methods:

• A comparative study design was employed, analyzing patients hospitalized for over one year.
• Patients were categorized into VRE-A, VRE-O, and VRE colonization groups.
• Statistical analysis included Fisher exact test and Student t test, with significance set at p < 0.05.

Main Results:

• Out of 89 VRE cases, six were VRE-A, 24 were VRE-O, and 59 were VRE colonization.
• All six VRE-A patients had recent surgery prior to VRE isolation, significantly more than the VRE-O group (p = 0.0001).
• Despite successful VRE eradication with chloramphenicol, the VRE-A group experienced a 50% mortality rate.

Conclusions:

• Vancomycin-resistant enterococcus (VRE) must be recognized as an emerging nosocomial pathogen causing potentially fatal intraabdominal infections.
• The postsurgical setting is a critical environment for the development of VRE-A.
• Further research is needed to fully understand the impact of treatment on the ultimate outcomes of VRE-A.