ALTERNATE ANTIMICROBIAL THERAPY FOR VANCOMYCIN-RESISTANT ENTEROCOCCI BURN WOUND INFECTIONS

Survival after a major thermal burn is precarious and fraught with dif ficult complications associated with hypermetabolism, gut or respirato ry dysfunction, and infection. Clinicians must be cognizant of a new t hreat to the patient with burn injuries-the emergence of vancomycin-re sistant enterococci (VRE). In an analysis of 31 clinical isolates obta ined during acute burn hospitalization, an optimal antimicrobial thera py for VRE has been identified; All VRE cultures were inoculated to th e MicroScan Gram-Positive Breakpoint Combo Panel #8 (Dade Microscan, I nc, Sacramento, Calif), which speciates the enterococci, provides anti microbial susceptibility patterns (including vancomycin) and a biotype , and examines streptomycin and gentamicin synergy. Eleven (35.5%) of the 31 isolates were identified as E faecium and 20 (64.5%) as E faeca lis. All isolates were susceptible to chloramphenicol and tetracycline , whereas only half were sensitive to gentamicin synergy screen. All o ther antimicrobials screened against VRE were either ineffective or of Limited effect. Our preliminary data supports the initiation of chlor amphenicol therapy when a VRE burn wound infection is encountered or s uspected.