VANCOMYCIN-RESISTANT-ENTEROCOCCI - COLONIZATION OF 24 PATIENTS ON A PEDIATRIC ONCOLOGY UNIT

Background Colonization with multidrug-resistant vancomycin-resistant- enterococci (VRE) could become a serious problem, since there is no pr oven therapy in case of an infection or in case of transfer of glycope ptid-resistance to other organisms. Patients Description of 24 from 48 pediatric oncology patients with VRE-colonization. Methods Stool samp les were taken from all patients of our pediatric oncology unit from M arch 1996 until June 1997. Barrier isolation was introduced in May 199 6, a prudent use of glycopeptid antibiotica in July 1996. Results 193 stool sample examinations demonstrated that 24 (50%) of the 48 patient s were colonized with VRE. 11 (46%) of these 24 patients were VRE-carr iers at the time of their first examination; 9 (37%) patients acquired VRE during their therapy and 4 (17%) patients had come from other hos pitals and already were VRE-positive when they entered our unit. In Ma rch 1997, one year after the outbreak only four patients still were VR E-positive, in June 1997 all of them were VRE-negative. The average ti me of colonization was 12,5 weeks. 17 (70%) of the 24 colonized patien ts had received glycopeptide antibiotics, 16 of them within two months before the appearance of VRE in their stool. Five colonized patients died, four of them because of their oncological illness, one because o f a sepsis without proof of VRE in his blood. In the end none of our p atients suffered from a VRE-infection, and besides that, the transfer of glycopeptid-resistance to other organisms was not observed.Conclusi on With barrier isolation and a Very restrictive use of glycopeptid-an tibiotica, colonization can be decreased and even stopped. Inspite of the high number of colonized patients no VRE-infectious disease occurr ed.