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Vancomycin-resistant Enterococcus faecium colonization in children

N Singh-Naz1, A Sleemi, A Pikis

  • 1Departments of Infectious Diseases, Children's National Medical Center, George Washington University School of Medicine, Washington, D.C. 20010, USA. nsingh@cnmc.org

Journal of Clinical Microbiology
|January 16, 1999
PubMed
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Pediatric vancomycin-resistant Enterococcus (VRE) colonization is linked to young age and specific chemotherapy agents. Gastrointestinal VRE colonization in children can act as a reservoir for transmission within hospitals.

Area of Science:

  • Pediatric Infectious Diseases
  • Hospital Epidemiology
  • Molecular Microbiology

Background:

  • Nosocomial vancomycin-resistant Enterococcus (VRE) infections are infrequently reported in pediatric patients.
  • Previous studies lacked multivariate analyses to identify independent risk factors for VRE colonization in this population.

Purpose of the Study:

  • To identify independent risk factors for VRE colonization in pediatric patients admitted to a hematology/oncology unit.
  • To characterize the molecular epidemiology of VRE isolates in this cohort.

Main Methods:

  • A cohort study design was employed.
  • Surveillance cultures were used to assess VRE colonization rates.
  • Multivariate logistic regression analysis identified risk factors.

Related Experiment Videos

  • Pulsed-field gel electrophoresis (PFGE) was utilized for molecular typing of VRE isolates.

    • Main Results:

    • The VRE colonization rate was 24%, with all isolates identified as Enterococcus faecium.
    • Independent risk factors for VRE colonization included young age, chemotherapy with antineoplastic agents, cefotaxime, vancomycin, and ceftazidime.
    • PFGE analysis revealed two major clusters of VRE isolates, indicating potential transmission events.

    Conclusions:

    • Young children with VRE gastrointestinal colonization, even without clinical infection, can serve as a reservoir for VRE spread.
    • Understanding these risk factors is crucial for implementing targeted infection control strategies in pediatric hematology/oncology units.