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Published on: July 9, 2012
Risk of vancomycin-resistant enterococci bloodstream infection among patients colonized with vancomycin-resistant
Ahu Kara1, İlker Devrim1, Nuri Bayram1
1Department of Pediatric Infectious Disease, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Background:
Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections.
Aim:
In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months.
Method:
A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection.
Findings:
Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3%) while they were hospitalized at intensive care units; while the remaining majority (33.0%) were hospitalized at hematology-oncology department. Vancomycin-resistant enterococci bacteremia was present only in three (1.55%) patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient) and intensive chemotherapy (two patients).
Conclusion:
In conclusion, our study found that 1.55% of vancomycin-resistant enterococci-colonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycin-resistant enterococci bloodstream infections.
Insights
Vancomycin-resistant enterococci colonization in children rarely leads to bloodstream infections (1.55%). Immunosuppression, particularly from chemotherapy or HIV, is a critical factor in developing these infections.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Hospital Epidemiology
Background:
- Vancomycin-resistant enterococci (VRE) colonization increases infection risk.
- Understanding VRE bloodstream infections (VRE-BSI) in pediatric populations is crucial.
Purpose of the Study:
- To report the incidence of VRE-BSI following VRE colonization in pediatric patients.
- To identify risk factors for VRE-BSI in this cohort.
Main Methods:
- Retrospective cohort study of pediatric patients with newly detected gastrointestinal VRE colonization.
- Evaluation of VRE isolates for infection evidence within 18 months of initial detection.
- Study conducted at a tertiary teaching hospital in Izmir, Turkey (January 2009 - December 2012).
Main Results:
- 216 pediatric patients with VRE colonization were included.
- VRE colonization was prevalent in intensive care units (62.3%) and hematology-oncology departments (33.0%).
- Only 1.55% (3 patients) developed VRE-BSI; all were immunosuppressed (HIV or chemotherapy).
Conclusions:
- The incidence of VRE-BSI following colonization in pediatric ICU and hematology-oncology patients is low (1.55%).
- Immunosuppression is identified as the primary risk factor for developing VRE-BSI in colonized children.
- Findings highlight the importance of monitoring immunosuppressed pediatric patients colonized with VRE.
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