Kara Ahu, Devrim İlker, Bayram Nuri, Katipoğlu Nagehan, Kıran Ezgi, Oruç Yeliz, Demiray Nevbahar, Apa Hurşit, Gülfidan Gamze
Department of Pediatric Infectious Disease, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Department of Pediatric Infectious Disease, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Braz J Infect Dis. 2015 Jan-Feb;19(1):58-61. doi: 10.1016/j.bjid.2014.09.010. Epub 2014 Dec 18.
Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections.
In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months.
A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection.
Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3%) while they were hospitalized at intensive care units; while the remaining majority (33.0%) were hospitalized at hematology-oncology department. Vancomycin-resistant enterococci bacteremia was present only in three (1.55%) patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient) and intensive chemotherapy (two patients).
In conclusion, our study found that 1.55% of vancomycin-resistant enterococci-colonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycin-resistant enterococci bloodstream infections.
据报道，耐万古霉素肠球菌定植会增加包括血流感染在内的感染发生风险。
在本研究中，我们旨在分享在18个月期间儿科人群中胃肠道耐万古霉素肠球菌定植后发生耐万古霉素肠球菌血流感染的经验。
纳入2009年1月至2012年12月期间在土耳其伊兹密尔一家拥有400张床位的三级教学医院住院的儿童回顾性队列，这些儿童在胃肠道耐万古霉素肠球菌定植的常规监测中被新检测出耐万古霉素肠球菌定植。对初次检测后18个月内发现的所有耐万古霉素肠球菌分离株进行感染证据评估。
216例耐万古霉素肠球菌患者纳入研究。136例患者（62.3%）在重症监护病房住院期间检测到耐万古霉素肠球菌定植；其余大多数（33.0%）在血液肿瘤科住院。仅3例（1.55%）患者出现耐万古霉素肠球菌菌血症。所有这些患者均因人类免疫缺陷病毒（1例患者）和强化化疗（2例患者）而免疫抑制。
总之，我们的研究发现，在儿科重症监护病房和血液/肿瘤患者中，1.55%的耐万古霉素肠球菌定植儿童发生了耐万古霉素肠球菌血流感染；根据我们的研究结果，我们认为免疫抑制是发生耐万古霉素肠球菌血流感染的关键因素。
