title: Vancomycin-resistant Enterococcus in pediatric oncology patients: balancing infection prevention and family-centered care.
abstract: In February 2007, we experienced an abrupt 8-fold increase in vancomycin-resistant Enterococcus (VRE)-positive pediatric hematology/oncology patients in isolation per day, peaking at 12 patients in isolation per day in June 2007. We enforced and expanded infection prevention practices and initiated a rigorous 6-month clearance process. After noting an eventual decrease, we modified clearance to a 3-month process, maintaining <1 patient/day in isolation by June 2009, subjectively improving family and staff satisfaction after this 2-year process. VRE infection was relatively uncommon (7.8%), although continued VRE colonization portended an overall poorer prognosis.
authors.affiliation: Department of Pediatrics, Division of Infectious Disease, CHOC Children's Hospital, Orange, CA 92868, USA. jsingh@choc.org
authors.forename: Jasjit
authors.initials: J
authors.lastname: Singh
authors.forename: Samuel
authors.initials: S
authors.lastname: Esparza
authors.forename: Melanie
authors.initials: M
authors.lastname: Patterson
authors.forename: Kate
authors.initials: K
authors.lastname: Vogel
authors.forename: Bijal
authors.initials: B
authors.lastname: Patel
authors.forename: Wendi
authors.initials: W
authors.lastname: Gornick
mesh_terms: D002648:Child; D004196:Disease Outbreaks / Q000517:prevention & control*; D016983:Enterococcus / Q000187:drug effects*; D005190:Family; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D017053:Infection Control; D016522:Oncology Service, Hospital; D018802:Patient-Centered Care; D011379:Prognosis; D012307:Risk Factors; D020713:Vancomycin Resistance