Rajaee Behbahani Mahrokh, Moradi Farhad, Dezhkam Asiyeh, Khashei Reza
Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Pediatric Infectious Diseases, Shiraz University of Medical Sciences, Shiraz, Iran.
Heliyon. 2024 Aug 9;10(16):e36028. doi: 10.1016/j.heliyon.2024.e36028. eCollection 2024 Aug 30.
Today, one of the important challenges related to the emergence of antibiotic resistance among hospital-acquired infections is Vancomycin-Resistant Enterococci (VRE). The identification of the hospital transfer pattern and accurate laboratory diagnosis can be effective in preventing or selecting the appropriate antibiotics for the treatment of these types of infections, especially in hemodialysis patients.
This report discusses the hospitalization of a 2.5-year-old boy with End-Stage Renal Disease (ESRD) and Focal Segmental Glomerulosclerosis (FSGS) at a nephrology center in a tertiary hospital. The patient received hemodialysis treatment, followed by an abdominal tap, which revealed an infection. Peritoneal and blood cultures were conducted using the BACT/ALERT®3D instrument, and the results indicated a bacterial infection during the hospital stay. Further analysis confirmed that the infection was caused by enterococci, and susceptibility testing revealed that the isolated strain was resistant to vancomycin. Fortunately, the enterococci infection responded well to linezolid antibiotic treatment, administered at a dose of 600 mg PO/IV q12hr for 14 days.
This report highlights the importance of healthcare workers being aware of the transmission routes of VRE among patients. It emphasizes the need for appropriate hand hygiene, sterility of extracorporeal devices, and proper catheter care in medical centers.
如今,医院获得性感染中与抗生素耐药性出现相关的重要挑战之一是耐万古霉素肠球菌(VRE)。确定医院内传播模式并进行准确的实验室诊断,对于预防或选择合适的抗生素治疗这类感染有效,尤其是在血液透析患者中。
本报告讨论了一名2.5岁患有终末期肾病(ESRD)和局灶节段性肾小球硬化症(FSGS)的男孩在一家三级医院的肾脏病中心住院的情况。患者接受了血液透析治疗,随后进行了腹腔穿刺,结果显示存在感染。使用BACT/ALERT®3D仪器进行了腹水和血液培养,结果表明在住院期间存在细菌感染。进一步分析证实感染由肠球菌引起,药敏试验显示分离出的菌株对万古霉素耐药。幸运的是,该肠球菌感染对利奈唑胺抗生素治疗反应良好,以600毫克口服/静脉注射,每12小时一次,共治疗14天。
本报告强调了医护人员了解患者中VRE传播途径的重要性。它强调了医疗中心进行适当手部卫生、体外装置无菌操作和正确导管护理的必要性。