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Failure to develop vancomycin-resistant Enterococcus with oral vancomycin treatment of Clostridium difficile
Cassandra D Salgado1, Eve T Giannetta, Barry M Farr
1Department of Medicine, East Carolina University, Brody School of Medicine, 600 Moye Blvd., Room 3E-113, Greenville, NC 27858, USA.
Infection Control and Hospital Epidemiology
|June 11, 2004
Summary
Oral vancomycin therapy did not lead to vancomycin-resistant Enterococcus (VRE) colonization in patients. This study suggests oral vancomycin, even with other antibiotic use, may not be a significant risk factor for VRE positivity.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Pharmacy
Background:
- Oral vancomycin therapy has been historically associated with an increased risk of vancomycin-resistant Enterococcus (VRE) colonization.
- Understanding risk factors for VRE acquisition is crucial for infection control.
Purpose of the Study:
- To evaluate the VRE colonization status of patients receiving oral vancomycin.
- To determine if oral vancomycin therapy is an independent risk factor for VRE positivity.
Main Methods:
- Retrospective review of medical records for patients receiving oral vancomycin between August 1995 and February 2001.
- Analysis of perirectal VRE cultures and patient histories, including other antibiotic exposures.
- Patients were placed under contact isolation until VRE colonization was ruled out.
Main Results:
- Twenty-six courses of oral vancomycin were administered to 22 patients.
- VRE colonization status was assessed post-therapy in 20 patients (91%).
- No patients became VRE culture positive during a median follow-up of 18 days, despite concurrent or prior antibiotic use in all patients.
Conclusions:
- Oral vancomycin therapy, even in the presence of other risk factors like anti-anaerobic or parenteral vancomycin use, did not result in VRE positivity in this patient cohort.
- These findings suggest that oral vancomycin may not be a significant independent risk factor for VRE colonization in patients not previously exposed to VRE.