VANCOMYCIN-RESISTANT ENTEROCOCCI IN PEDIATRIC HEMATOLOGY - NO PANIC PLEASE

Do immunocompromised children, carrying vancomyin-resistant enteroeocc i (VRE) need to be treated? For 3 years, 230 children with chemotherap y and/or bone-marrow transplantation (BMT) received amikacin for gut d econtamination and rinced their mouth with solutions including vancomy cin or not? according to the duration and severity of neutropenia. Som e patients were isolated, others were at home with ambulatory treatmen t. The first-line antibiotherapy was piperacillin-amikacin-vancomycin in the chemotherapy unit, imipenem-vancomycin in the BMT unit. Once-a- week, the laboratory used to check the efficiency of decontamination p rocedures and look for emerging resistant bacteria. Four patients were identified as VRE carriers in their gut flora. The fecal carriage was long-lasting in a single patient, for whom attempts of eradication fa iled. No patient underwent VRE bacteremia. From our experience, it see ms reasonable to neglect enterococcal eradication, provided that hygie nic measures are strictly applied.