Cargando…
Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit
PURPOSE: Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing inf...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784302/ https://www.ncbi.nlm.nih.gov/pubmed/29403213 http://dx.doi.org/10.4103/JLP.JLP_32_17 |
_version_ | 1783295422352064512 |
---|---|
author | Amberpet, Rajesh Sistla, Sujatha Parija, Subhash Chandra Rameshkumar, Ramachandran |
author_facet | Amberpet, Rajesh Sistla, Sujatha Parija, Subhash Chandra Rameshkumar, Ramachandran |
author_sort | Amberpet, Rajesh |
collection | PubMed |
description | PURPOSE: Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing infection up to 5–10 folds. The aim of this study was to determine the rates of VRE colonization among the patients admitted to pediatric ICU (PICU) and risk factors associated with it. MATERIALS AND METHODS: Rectal swabs were collected after 48 h of admission to PICU from 198 patients. The samples were inoculated onto bile esculin sodium azide agar with 6 mg/ml of vancomycin. Growth on this medium was identified by the standard biochemical test, and minimum inhibitory concentration of vancomycin and teicoplanin was detected by agar dilution method. Resistance genes for vancomycin were detected by polymerase chain reaction. Risk factors were assessed by logistic regression analysis. RESULTS: The rates of VRE colonization in patients admitted to PICU was 18.6%. The majority of the isolates were Enterococcus faecium (75.6%) followed by Enterococcus faecalis (24.4%). One patient acquired a VRE bloodstream infection (2.6%) among colonized patients, and none of the noncolonized patients acquired the infection. Consumption of vancomycin was found to be the only risk factor significantly associated with VRE colonization. CONCLUSION: Routine surveillance and isolation of patients found to be VRE colonized may not be possible in tertiary care hospitals; however, educating health-care workers, promoting handwashing with antiseptic soaps or solutions, and antibiotic Stewardship policy may help in the reduction of vancomycin resistance and VRE colonization. |
format | Online Article Text |
id | pubmed-5784302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-57843022018-02-05 Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit Amberpet, Rajesh Sistla, Sujatha Parija, Subhash Chandra Rameshkumar, Ramachandran J Lab Physicians Original Article PURPOSE: Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing infection up to 5–10 folds. The aim of this study was to determine the rates of VRE colonization among the patients admitted to pediatric ICU (PICU) and risk factors associated with it. MATERIALS AND METHODS: Rectal swabs were collected after 48 h of admission to PICU from 198 patients. The samples were inoculated onto bile esculin sodium azide agar with 6 mg/ml of vancomycin. Growth on this medium was identified by the standard biochemical test, and minimum inhibitory concentration of vancomycin and teicoplanin was detected by agar dilution method. Resistance genes for vancomycin were detected by polymerase chain reaction. Risk factors were assessed by logistic regression analysis. RESULTS: The rates of VRE colonization in patients admitted to PICU was 18.6%. The majority of the isolates were Enterococcus faecium (75.6%) followed by Enterococcus faecalis (24.4%). One patient acquired a VRE bloodstream infection (2.6%) among colonized patients, and none of the noncolonized patients acquired the infection. Consumption of vancomycin was found to be the only risk factor significantly associated with VRE colonization. CONCLUSION: Routine surveillance and isolation of patients found to be VRE colonized may not be possible in tertiary care hospitals; however, educating health-care workers, promoting handwashing with antiseptic soaps or solutions, and antibiotic Stewardship policy may help in the reduction of vancomycin resistance and VRE colonization. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5784302/ /pubmed/29403213 http://dx.doi.org/10.4103/JLP.JLP_32_17 Text en Copyright: © 2018 Journal of Laboratory Physicians http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Amberpet, Rajesh Sistla, Sujatha Parija, Subhash Chandra Rameshkumar, Ramachandran Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title | Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title_full | Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title_fullStr | Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title_full_unstemmed | Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title_short | Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit |
title_sort | risk factors for intestinal colonization with vancomycin resistant enterococci’ a prospective study in a level iii pediatric intensive care unit |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784302/ https://www.ncbi.nlm.nih.gov/pubmed/29403213 http://dx.doi.org/10.4103/JLP.JLP_32_17 |
work_keys_str_mv | AT amberpetrajesh riskfactorsforintestinalcolonizationwithvancomycinresistantenterococciaprospectivestudyinaleveliiipediatricintensivecareunit AT sistlasujatha riskfactorsforintestinalcolonizationwithvancomycinresistantenterococciaprospectivestudyinaleveliiipediatricintensivecareunit AT parijasubhashchandra riskfactorsforintestinalcolonizationwithvancomycinresistantenterococciaprospectivestudyinaleveliiipediatricintensivecareunit AT rameshkumarramachandran riskfactorsforintestinalcolonizationwithvancomycinresistantenterococciaprospectivestudyinaleveliiipediatricintensivecareunit |