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Treatment of vancomycin-resistant Enterococcus faecium infections
1Department of Medicine, University of Massachusetts Medical School, Worcester, USA.
Archives of Internal Medicine
|December 9, 1996
Summary
Vancomycin-resistant enterococci (VRE) infections in patients often resolve without specific antimicrobial therapy. Key interventions include removing invasive devices, surgical debridement, and drainage for VRE infections.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Antimicrobial Resistance
Background:
- Vancomycin-resistant enterococci (VRE) pose a significant challenge due to limited effective treatment options.
- Understanding the clinical characteristics and outcomes of VRE infections is crucial for patient management.
Purpose of the Study:
- To define the clinical characteristics of patients infected with vancomycin-resistant enterococci (VRE).
- To determine the outcomes of VRE infections in the absence of effective antimicrobial therapy.
Main Methods:
- Retrospective chart review of 28 patients with VRE infections.
- Data collected included demographics, clinical findings, comorbidities, procedures, and treatment outcomes.
Main Results:
- VRE infections encompassed bacteremia, surgical site infections (SSIs), peritonitis, abscesses, urinary tract infections (UTIs), and soft tissue infections (STIs).
- Central-line-related bacteremia resolved with line removal; SSIs, STIs, and abscesses resolved with surgical debridement and drainage.
- Most UTIs resolved without specific VRE-directed therapy, though some were treated with nitrofurantoin.
Conclusions:
- VRE line-related bacteremias can be managed by line removal alone.
- Surgical site infections, STIs, and abscesses often resolve with debridement and drainage.
- Removal of foreign devices, debridement, and surgical drainage are critical for resolving VRE infections.