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A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures
Published on: February 10, 2011
Multidrug-resistant Enterococcus faecium. An untreatable nosocomial pathogen
1Division of Infectious Diseases, Brooklyn Hospital Center, New York.
Abstract:
The prevalence of enterococci and nosocomial pathogens has increased over the past 15 years. They have become increasingly resistant to agents traditionally useful in the treatment of invasive diseases due to enterococci. Vancomycin resistance, first described in clinical isolates in 1988, has disseminated worldwide. It is usually associated with high-level resistance to penicillins and aminoglycosides rendering the treatment of patients with vancomycin-resistant enterococci very difficult. Several investigators have reported mortality rates greater than 50% for vancomycin-resistant enterococcal bacteraemia. Risk factors associated with vancomycin-resistant enterococcal bacteraemia include prolonged hospital stay, neutropenia, prior oral or parenteral vancomycin use, and broad spectrum antibiotics. Since there is no uniformly effective antimicrobial therapy for patients infected with vancomycin-resistant enterococci, preventing of the spread of infection with the rigorous application of barrier precautions and other infectious control techniques is of paramount importance.
Insights
Vancomycin-resistant enterococci (VRE) are increasingly prevalent nosocomial pathogens. Due to limited treatment options and high mortality, rigorous infection control is crucial to prevent VRE spread.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Rising prevalence of enterococci and nosocomial pathogens over 15 years.
- Increasing resistance to traditional antimicrobial agents, including vancomycin.
- Vancomycin resistance in enterococci (VRE) first identified in 1988 and now global.
Purpose of the Study:
- To highlight the challenges posed by vancomycin-resistant enterococci (VRE).
- To discuss the implications of VRE resistance to multiple antibiotics.
- To emphasize the importance of infection control measures for VRE.
Main Methods:
- Review of clinical literature on enterococcal prevalence and resistance.
- Analysis of risk factors associated with vancomycin-resistant enterococcal infections.
- Assessment of treatment difficulties and mortality rates for VRE infections.
Main Results:
- VRE exhibits high-level resistance to penicillins and aminoglycosides.
- Treatment of VRE infections is extremely difficult, with reported mortality rates exceeding 50% for bacteremia.
- Key risk factors include prolonged hospitalization, neutropenia, and prior vancomycin or broad-spectrum antibiotic use.
Conclusions:
- There is a lack of uniformly effective antimicrobial therapies for VRE infections.
- Preventing the spread of VRE through stringent barrier precautions and infection control techniques is paramount.
- Focus on infection prevention due to therapeutic limitations.
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