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Alternate antimicrobial therapy for vancomycin-resistant enterococci burn wound infections
J P Heggers1, L McCoy, B Reisner
1Shriners Burns Institute, Galveston, TX 77550, USA.
The Journal of Burn Care & Rehabilitation
|October 28, 1998
Summary
Vancomycin-resistant enterococci (VRE) pose a significant threat to burn patients. This study identified chloramphenicol and tetracycline as effective treatments for VRE infections in burn wounds.
Area of Science:
- Infectious Diseases
- Burn Care
- Microbiology
Background:
- Major thermal burns present complex challenges, including hypermetabolism, organ dysfunction, and infection.
- Vancomycin-resistant enterococci (VRE) represent an emerging and serious threat to patients with burn injuries.
Purpose of the Study:
- To identify optimal antimicrobial therapies for vancomycin-resistant enterococci (VRE) infections in burn patients.
- To evaluate the susceptibility patterns of VRE clinical isolates from burn patients to various antimicrobial agents.
Main Methods:
- Analysis of 31 clinical isolates of VRE obtained during acute burn hospitalization.
- VRE cultures were tested using the MicroScan Gram-Positive Breakpoint Combo Panel #8 for speciation and antimicrobial susceptibility.
- Evaluation included vancomycin resistance, biotyping, and synergy screening for streptomycin and gentamicin.
Main Results:
- The study identified 11 (35.5%) isolates as Enterococcus faecium and 20 (64.5%) as Enterococcus faecalis.
- All VRE isolates demonstrated susceptibility to chloramphenicol and tetracycline.
- Only half of the isolates were sensitive to the gentamicin synergy screen, with other antimicrobials showing limited or no effect.
Conclusions:
- Chloramphenicol and tetracycline are effective antimicrobial agents against VRE isolates from burn wound infections.
- Preliminary data suggest initiating chloramphenicol therapy for suspected or confirmed VRE burn wound infections.