Results of Four-Year Rectal Vancomycin-Resistant Enterococci Surveillance in a Pediatric Hematology-Oncology Ward: From Colonization to Infection.
OBJECTIVE
To investigate the clinical impact of vancomycin-resistant enterococci (VRE) colonization in patients with hematologic malignancies and associated risk factors.


METHODS
Patients colonized and infected with VRE were identified from an institutional surveillance database between January 2010 and December 2013. A retrospective case-control study was performed to identify the risk factors associated with development of VRE infection in VRE-colonized patients.


RESULTS
Fecal VRE colonization was documented in 72 of 229 children (31.4%). Seven VRE-colonized patients developed subsequent systemic VRE infection (9.7%). Types of VRE infections included bacteremia (n=5), urinary tract infection (n=1), and meningitis (n=1). Enterococcus faecium was isolated in all VRE infections. Multivariate analysis revealed severe neutropenia and previous bacteremia with another pathogen as independent risk factors for VRE infection development in colonized patients [odds ratio (OR): 35.4, confidence interval (CI): 1.7-72.3, p=0.02 and OR: 20.6, CI: 1.3-48.6, p=0.03, respectively]. No deaths attributable to VRE occurred.


CONCLUSIONS
VRE colonization has important consequences in pediatric cancer patients.
Hacer
H
Aktürk
Murat
M
Sütçü
Ayper
A
Somer
İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey, Phone : +90 212 414 20 00 E-mail : drkaramans@yahoo.com.
Serap
S
Karaman
Manolya
M
Acar
Ayşegül
A
Ünüvar
Sema
S
Anak
Zeynep
Z
Karakaş
Aslı
A
Özdemir
Kutay
K
Sarsar
Derya
D
Aydın
Nuran
N
Salman
D001424:Bacterial Infections / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012007:Rectum / Q000382:microbiology*; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*