MULTIDRUG-RESISTANT ENTEROCOCCUS-FAECIUM - AN UNTREATABLE NOSOCOMIAL PATHOGEN

The prevalence of enterococci and nosocomial pathogens has increased o ver the past 15 years. They have become increasingly resistant to agen ts traditionally useful in the treatment of invasive diseases due to e nterococci. Vancomycin resistance, first described in clinical isolate s in 1988, has disseminated worldwide. It is usually associated with h igh-level resistance to penicillins and aminoglycosides rendering the treatment of patients with vancomycin-resistant enterococci very diffi cult. Several investigators have reported mortality rates greater than 50% for vancomycin-resistant enterococcal bacteraemia. Risk factors a ssociated with vancomycin-resistant enterococcal bacteraemia include p rolonged hospital stay, neutropenia, prior oral or parenteral vancomyc in use, and broad spectrum antibiotics. Since there is no uniformly ef fective antimicrobial therapy for patients infected with vancomycin-re sistant enterococci, preventing of the spread of infection with the ri gorous application of barrier precautions and other infectious control techniques is of paramount importance.