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Persistent vancomycin and high-level gentamicin-resistant Enterococcus faecium bacteremia and intra-aortic thrombus

N Hapnes1, A Twomey, S Knowles

  • 1Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. ninahapnes@hotmail.com

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 30, 2008
PubMed

Insights

Vancomycin-resistant Enterococcus (VRE) sepsis is a growing concern in intensive care. This case study details successful VRE treatment in a 10-day-old, extremely premature infant with high-level gentamicin resistance.

Area of Science:

  • Neonatal intensive care
  • Infectious diseases
  • Pharmacology

Background:

  • Vancomycin-resistant Enterococcus (VRE) sepsis presents significant treatment challenges, particularly in neonates.
  • Limited data exists on managing VRE infections in extremely premature infants.
  • Enterococcus faecium is a common cause of healthcare-associated infections.

Observation:

  • A 10-day-old infant, born at 23 weeks gestation, developed persistent bacteremia.
  • The infection was caused by Enterococcus faecium exhibiting resistance to vancomycin and high-level gentamicin.
  • Standard treatment protocols for VRE sepsis were considered challenging for this extremely premature neonate.

Findings:

  • Successful treatment of persistent Enterococcus faecium bacteremia was achieved.
  • The treatment involved a combination of vancomycin and high-level gentamicin therapy.
  • This approach demonstrated efficacy in a critically ill, extremely premature infant.

Implications:

  • This case highlights a potential therapeutic strategy for VRE sepsis in extremely premature neonates.
  • Further research is warranted to establish optimal VRE treatment guidelines for this vulnerable population.
  • Successful management of VRE in neonates can improve outcomes and reduce mortality.

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