Prevalence of vancomycin-resistant enterococci among children with end-stage renal failure. Mid-European Pediatric Peritoneal Dialysis Study Group.
To evaluate the prevalence of colonization with vancomycin-resistant enterococcus (VRE) in end-stage renal failure (ESRF), we screened the intestinal flora from 338 pediatric ESRF patients treated in 13 pediatric nephrology units in mid-Europe. Eighty-one patients were undergoing hemodialysis, 66 were undergoing chronic peritoneal dialysis, and 191 were transplant recipients. A total of 363 enterococcal strains were recovered from 232 patients. Twenty-seven enterococcal strains from 24 patients (7.1%) had reduced susceptibility to vancomycin (minimal inhibitory concentration [MIC], >4 microg/mL). Although two patients (0.6%) carried enterococci with high-level resistance to vancomycin (MIC, >32 microg/mL; i.e., VRE), strains of enterococcus with reduced susceptibility to vancomycin (ERSV) were recovered from the other 22 subjects. Past use of vancomycin (P = .05) and tacrolimus therapy (P = .011) were independent risk factors for ERSV or VRE carriage. Enterococcal infections occurred with a similar frequency among enterococcal carriers and noncarriers; no infections with VRE or ERSV were reported. In conclusion, the prevalence of ERSV carriage and the rate of VRE colonization among mid-European children and adolescents with ESRF currently are moderate and low, respectively.
von Baum
H
H
Institute of Hygiene, Department of Pediatrics, University of Heidelberg, Germany. heike_von_baum@med.uni-heidelberg.de
Schehl
J
J
Geiss
H K
HK
Schaefer
F
F
D000293:Adolescent; D000328:Adult; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects; D020713:Vancomycin Resistance
D016559:Tacrolimus