Abstract
Background and Objectives. The emergence of vancomycin-resistant enterococci (VRE) as nosocomial pathogens is a major problem in the US; in Europe, VRE nosocomial infections are uncommon and only rarely have been reported in Pediatric or Neonatal Units. The aim of this study is to report on the clinical and microbiological features of VRE infections in 3 children given hematopoietic stem cell transplantation (HSCT). Patients and methods. Five episodes of vancomycin-resistant Enterococcus faecium (VREF) infection were diagnosed in 3 children given an allogeneic HSCT. Molecular methods, such as random amplification of polymorphic DNA (RAPD) fingerprinting and automated ribotyping, were used in order to define the circulation of strains. Results. All the isolates were resistant to all commercially available agents and showed the VanA genotypic profile. All children were successfully treated with the combination of quinupristin/dalfopristin (QD) plus teicoplanin (TEC), although treatment was not sufficient to eradicate the micro-organism promptly from the gastrointestinal tract. All our children are still alive. After the first isolation of VRE, a surveillance protocol was started and we documented that the rate of colonization in children and their mother was less than 1.5%. The RAPD method demonstrated the possible nosocomial transmission of one strain. Interpretation and Conclusions. Our experience demonstrates that VRE infection is a life-threatening complication in children given HSCT. Prompt diagnosis of this infection and its treatment with the combination of QD and TEC and successfully manage this severe infection in profoundly immunocompromised patients. (C) 2000, Ferrata Storti Foundation.
| Original language | English |
|---|---|
| Pages (from-to) | 1158-1164 |
| Number of pages | 7 |
| Journal | Haematologica |
| Volume | 85 |
| Issue number | 11 |
| Publication status | Published - 2000 |
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Keywords
- Automated ribotyping
- Bone marrow transplantation
- Quinupristin/dalfopristin
- RAPD
- Teicoplanin
- Vancomycin-resistant enterococci
ASJC Scopus subject areas
- Hematology
Cite this
Vancomycin-resistant Enterococcus faecium infection in three children given allogeneic hematopoietic stem cell transplantation : Clinical and microbiological features. / Carretto, E.; Barbarini, D.; Locatelli, F.; Giraldi, E.; Pellegrini, N.; Perversi, L.; Grossi, P.; Marone, P.; Bonetti, F.
In: Haematologica, Vol. 85, No. 11, 2000, p. 1158-1164.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vancomycin-resistant Enterococcus faecium infection in three children given allogeneic hematopoietic stem cell transplantation
T2 - Clinical and microbiological features
AU - Carretto, E.
AU - Barbarini, D.
AU - Locatelli, F.
AU - Giraldi, E.
AU - Pellegrini, N.
AU - Perversi, L.
AU - Grossi, P.
AU - Marone, P.
AU - Bonetti, F.
PY - 2000
Y1 - 2000
N2 - Background and Objectives. The emergence of vancomycin-resistant enterococci (VRE) as nosocomial pathogens is a major problem in the US; in Europe, VRE nosocomial infections are uncommon and only rarely have been reported in Pediatric or Neonatal Units. The aim of this study is to report on the clinical and microbiological features of VRE infections in 3 children given hematopoietic stem cell transplantation (HSCT). Patients and methods. Five episodes of vancomycin-resistant Enterococcus faecium (VREF) infection were diagnosed in 3 children given an allogeneic HSCT. Molecular methods, such as random amplification of polymorphic DNA (RAPD) fingerprinting and automated ribotyping, were used in order to define the circulation of strains. Results. All the isolates were resistant to all commercially available agents and showed the VanA genotypic profile. All children were successfully treated with the combination of quinupristin/dalfopristin (QD) plus teicoplanin (TEC), although treatment was not sufficient to eradicate the micro-organism promptly from the gastrointestinal tract. All our children are still alive. After the first isolation of VRE, a surveillance protocol was started and we documented that the rate of colonization in children and their mother was less than 1.5%. The RAPD method demonstrated the possible nosocomial transmission of one strain. Interpretation and Conclusions. Our experience demonstrates that VRE infection is a life-threatening complication in children given HSCT. Prompt diagnosis of this infection and its treatment with the combination of QD and TEC and successfully manage this severe infection in profoundly immunocompromised patients. (C) 2000, Ferrata Storti Foundation.
AB - Background and Objectives. The emergence of vancomycin-resistant enterococci (VRE) as nosocomial pathogens is a major problem in the US; in Europe, VRE nosocomial infections are uncommon and only rarely have been reported in Pediatric or Neonatal Units. The aim of this study is to report on the clinical and microbiological features of VRE infections in 3 children given hematopoietic stem cell transplantation (HSCT). Patients and methods. Five episodes of vancomycin-resistant Enterococcus faecium (VREF) infection were diagnosed in 3 children given an allogeneic HSCT. Molecular methods, such as random amplification of polymorphic DNA (RAPD) fingerprinting and automated ribotyping, were used in order to define the circulation of strains. Results. All the isolates were resistant to all commercially available agents and showed the VanA genotypic profile. All children were successfully treated with the combination of quinupristin/dalfopristin (QD) plus teicoplanin (TEC), although treatment was not sufficient to eradicate the micro-organism promptly from the gastrointestinal tract. All our children are still alive. After the first isolation of VRE, a surveillance protocol was started and we documented that the rate of colonization in children and their mother was less than 1.5%. The RAPD method demonstrated the possible nosocomial transmission of one strain. Interpretation and Conclusions. Our experience demonstrates that VRE infection is a life-threatening complication in children given HSCT. Prompt diagnosis of this infection and its treatment with the combination of QD and TEC and successfully manage this severe infection in profoundly immunocompromised patients. (C) 2000, Ferrata Storti Foundation.
KW - Automated ribotyping
KW - Bone marrow transplantation
KW - Quinupristin/dalfopristin
KW - RAPD
KW - Teicoplanin
KW - Vancomycin-resistant enterococci
UR - http://www.scopus.com/inward/record.url?scp=0033645555&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033645555&partnerID=8YFLogxK
M3 - Article
C2 - 11064468
AN - SCOPUS:0033645555
VL - 85
SP - 1158
EP - 1164
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 11
ER -