1393 Evaluation of the Prevalence and Risk Factors for Colonization by Vancomycin-Resistant Enterococcus Among Pediatric Icu Patients on Admission

Abstract

Background: Our institution experienced an increase in the frequency of vancomycin-resistant enterococci (VRE) clinical isolates. Surveillance cultures upon hospital admission for patients at high risk is recommended. We sought to measure the prevalence and risk factors of VRE carriage among medical new patients in a Pediatric Intensive Care Unit in a university Children's Hospital. Method: We recorded the positive VRE samples from new patients entering the PICU from 10/10/2008 - 15/04/2010. Cases had positive VRE clinical cultures (perianal/stool samples) within 48 hours of hospital admission. Results: VRE carriage was 9,33% on admission(39 of 418 of new patients). 53,84% of the carriages had a recent previous hospitalization (33,33% of them being oncologic patients). 51,28 % of the cases had previous recorded antibiotic treatment. 46,16 % of the patients had no previous admission (33,33% of them being trauma patients). 3/39 patients developed sepsis with positive blood culture of E. faecalis(one), E. faecium (two). 3/39 of the carriages had abdominal infection with positive pus cultures of E. faecium. Conclusions: Our study demonstrates that recent previous hospitalization is not a significant predictor for identifying carriers on admission but previous antibiotic treatment and neoplastic disease are. The wide use of antibiotics among paediatric patients may be the answer. Early identification and isolation of VRE carriers among critically ill patients should supplement application of infectious control measures in an attempt to reduce nosocomial spread and burden.