Barbé G, Ploton C, Pondarré C, Bertrand Y, Souillet G, Philippe N
Laboratoire de Bactériologie, Faculté de Pharmacie (UPRES-EA 1655), Hôpital Debrousse, Lyon, France.
Pathol Biol (Paris). 1998 Jun;46(6):408-11.
Do immunocompromised children, carrying vancomycin-resistant enterococci (VRE) need to be treated? For 3 years, 230 children with chemotherapy and/or bone-marrow transplantation (BMT) received amikacin for gut decontamination and rinsed their mouth with solutions including vancomycin or not, according to the duration and severity of neutropenia. Some patients were isolated, others were at home with ambulatory treatment. The first-line antibio-therapy was piperacillin-amikacin-vancomycin in the chemotherapy unit, imipenem-vancomycin in the BMT unit. Once-a-week, the laboratory used to check the efficiency of decontamination procedures and look for emerging resistant bacteria. Four patients were identified as VRE carriers in their gut flora. The fecal carriage was long-lasting in a single patient, for whom attempts of eradication failed. No patient underwent VRE bacteremia. From our experience, it seems reasonable to neglect enterococcal eradication, provided that hygienic measures are strictly applied.
携带耐万古霉素肠球菌（VRE）的免疫功能低下儿童需要治疗吗？三年来，230名接受化疗和/或骨髓移植（BMT）的儿童根据中性粒细胞减少的持续时间和严重程度，接受阿米卡星进行肠道去污，并用含或不含万古霉素的溶液漱口。一些患者被隔离，另一些患者在家接受门诊治疗。化疗病房的一线抗生物疗法是哌拉西林-阿米卡星-万古霉素，BMT病房是亚胺培南-万古霉素。实验室每周检查一次去污程序的效果，并寻找新出现的耐药细菌。有四名患者在其肠道菌群中被鉴定为VRE携带者。一名患者的粪便携带情况持续时间较长，根除尝试失败。没有患者发生VRE菌血症。根据我们的经验，只要严格采取卫生措施，忽略肠球菌的根除似乎是合理的。
