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Vancomycin-resistant Enterococcus faecium in hospitalized children
L G Rubin1, V Tucci, E Cercenado
1Division of Pediatric Infectious Diseases, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Insights
Vancomycin-resistant Enterococcus faecium (VRE) colonization is common in pediatric oncology patients. Limiting vancomycin use and using contact isolation can help prevent VRE spread.
Area of Science:
- Infectious Diseases
- Epidemiology
- Pediatric Oncology
Background:
- Vancomycin-resistant Enterococcus faecium (VRE) poses a significant threat in healthcare settings.
- Colonization with VRE is a precursor to VRE infections, particularly in vulnerable populations.
Purpose of the Study:
- To determine the prevalence and risk factors for VRE colonization in pediatric oncology patients.
- To evaluate the effectiveness of interventions in preventing VRE colonization and spread.
Main Methods:
- A survey and case-control study design was employed.
- Data was collected from a pediatric oncology patient population within a children's hospital.
- Interventions included contact isolation and restriction of vancomycin prescribing.
Main Results:
- A high prevalence of VRE colonization was observed among pediatric oncology patients.
- Prolonged hospitalization and the use of vancomycin and other intravenous antibiotics were associated with VRE colonization.
- Contact isolation and vancomycin restriction were linked to the prevention of VRE colonization.
Conclusions:
- Vancomycin use may increase the risk of VRE colonization.
- VRE can spread nosocomially within healthcare facilities.
- Contact isolation and judicious vancomycin use are effective strategies to prevent VRE transmission.
Objective:
Determine the epidemiology and risk factors for colonization with vancomycin-resistant Enterococcus faecium.
Design:
Survey; case-control study.
Setting:
Children's hospital.
Patients:
Pediatric oncology patients.
Intervention:
Contact isolation, restriction of vancomycin prescribing.
Results:
There was a high prevalence of colonization with vancomycin-resistant enterococci among pediatric oncology patients. The length of hospitalization and the administration of vancomycin and other intravenous antibiotics was associated with colonization. Prevention of colonization was associated with restriction of vancomycin use and contact isolation.
Conclusions:
Vancomycin use may predispose to colonization with vancomycin-resistant E faecium. Vancomycin-resistant E faecium may be nosocomially spread. Contact isolation and restriction of vancomycin use may prevent spread of vancomycin-resistant E faecium.