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Serious infections caused by multiply-resistant Enterococcus faecium
J J Wade1, N Rolando, R Williams
1Dulwich Public Health Laboratory, London, U.K.
Abstract:
Three liver transplant patients developed serious intraabdominal infections and recurrent bacteremias due to strains of Enterococcus faecium with high-level resistance to vancomycin. The enterococci were also resistant to all other antibacterials except pristinamycin, which, given orally, proved ineffective. One strain was sensitive to tetracycline. Increasingly, clinicians are likely to encounter infections caused by multiply-resistant enterococci, and these cases illustrate the seriousness of such infections in compromised patients.
Insights
High-level vancomycin-resistant Enterococcus faecium caused severe infections in three liver transplant patients. These multiply-resistant strains highlight the critical challenges in treating infections in immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Transplantation Medicine
- Microbiology
Background:
- Enterococcus faecium is a common cause of healthcare-associated infections.
- High-level vancomycin resistance in enterococci (HLR-VAE) poses significant treatment challenges.
- Liver transplant recipients are particularly vulnerable to serious infections due to immunosuppression.
Observation:
- Three liver transplant patients experienced severe intraabdominal infections and recurrent bacteremia.
- The causative agent was identified as Enterococcus faecium with high-level vancomycin resistance.
Findings:
- The resistant enterococci strains demonstrated resistance to nearly all tested antibacterials.
- Pristinamycin was ineffective orally, though one strain showed sensitivity to tetracycline.
Implications:
- Clinicians must anticipate and manage infections caused by multiply-resistant enterococci.
- These cases underscore the critical threat posed by multi-drug resistant organisms in immunocompromised patients, necessitating novel therapeutic approaches.