Korean J Pediatr Infect Dis.  2007 Nov;14(2):162-170. 10.14776/kjpid.2007.14.2.162.

Clinical implications on vancomycin-resistant enterococci isolated f rom the sp ecimen of pediatric patients in a university hosp ital

• Park YH
• Kim KJ
• Kim KH
• Chun JK
• Lee TJ
• Kim DS
• Park ES

• KMID: 2439949
• DOI: http://doi.org/10.14776/kjpid.2007.14.2.162

Abstract

PURPOSE
While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection.
METHODS
We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms.
RESULTS
The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998.
CONCLUSION
VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.

Keyword

Vancomycin-resistant enterococci; Pediatric population; Antibiotics; Infection control; Surveillance

MeSH Terms

Anti-Bacterial Agents
Cephalosporins
Colon
Glycopeptides
Humans
Infection Control
Intensive Care Units
Prevalence
Retrospective Studies
Risk Factors
Tetracycline
Vancomycin-Resistant Enterococci*
Anti-Bacterial Agents
Cephalosporins
Glycopeptides
Tetracycline