Risk of vancomycin-resistant enterococci bloodstream infection among patients colonized with vancomycin-resistant enterococci

Braz J Infect Dis. 2015 Jan-Feb;19(1):58-61. doi: 10.1016/j.bjid.2014.09.010. Epub 2014 Dec 18.

Abstract

Background: Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections.

Aim: In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months.

Method: A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection.

Findings: Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3%) while they were hospitalized at intensive care units; while the remaining majority (33.0%) were hospitalized at hematology-oncology department. Vancomycin-resistant enterococci bacteremia was present only in three (1.55%) patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient) and intensive chemotherapy (two patients).

Conclusion: In conclusion, our study found that 1.55% of vancomycin-resistant enterococci-colonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycin-resistant enterococci bloodstream infections.

Keywords: Bloodstream infections; Colonization; Immunosupression; Vancomycin-resistant enterococcus.

MeSH terms

  • Adolescent
  • Bacteremia / epidemiology
  • Bacteremia / immunology
  • Bacteremia / microbiology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross Infection / epidemiology
  • Cross Infection / immunology
  • Cross Infection / microbiology*
  • Female
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / immunology
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Immunocompromised Host
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Pediatric
  • Male
  • Retrospective Studies
  • Risk Factors
  • Vancomycin-Resistant Enterococci*