Korean J Pediatr Infect Dis.  2001 Nov;8(2):199-205. 10.14776/kjpid.2001.8.2.199.

Clinical Observations in Vancomycin-Resistant Enterococci Isolated from Pediatric Patients

• Lee DW
• Lee KJ
• Jang GC
• Kim DS
• Lee KW
• Park ES

• KMID: 2440186
• DOI: http://doi.org/10.14776/kjpid.2001.8.2.199

Abstract

PURPOSE
Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics
METHODS
We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected.
RESULTS
We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P < 0.05). The cases of superinfection is higher in the ICU group than in non ICU group.
CONCLUSION
In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

Keyword

Vancomycin resistant enterococci; ICU group; Surveillance; Superinfection

MeSH Terms

Anti-Bacterial Agents
Cross Infection
Disease Outbreaks
Enterococcus faecium
Hospitalization
Humans
Pediatrics
Retrospective Studies
Superinfection
Teicoplanin
Tetracycline
Vancomycin
Vancomycin-Resistant Enterococci*
Anti-Bacterial Agents
Teicoplanin
Tetracycline
Vancomycin