Vancomycin-resistant enterococcus colonization and infection in children: six-year follow-up

Vancomycin-resistant enterococci (VRE) have become a major concern in medical practice. Asymptomatic VRE colonization of the gastrointestinal tract may lead to infection. In this study, which included patients who stayed in our hospital between 2006 and 2011, we looked at the cases of 342 patients with VRE colonization and 19 patients with VRE infection. Vancomycin and carbapenem exposure and intestinal disorders were significantly more common in patients with VRE infection than in those with VRE colonization (p=0.02/0.04/0.04 respectively). Secondary immune deficiency was significantly more common in VRE-colonized patients than in VRE-infected patients (p=0.03). VRE colonization time was significantly related with young age, presence of intravenous catheter, presence of mechanical ventilation, length of hospital stay, length of hospitalization before and after VRE isolation, length of ICU stay before and after VRE isolation, total ICU stay, antibiotic exposure within 3 months, hospitalization (in our hospital) within 3 months, and having a site of infection other than VRE (p=0.01/ 0.01/ 0.04/ <0.001/0.02/ <0.001/ 0.002/ 0.006/ 0.002/ 0.004/ 0.01/ 0.002, respectively). Overall mortality and sepsis was more common in the VRE-infected group than in the VRE-colonized group. Taking into consideration limiting antibiotic usage in potential cases and screening for patients at risk could be beneficial in terms of limiting VRE infection and colonization.