Rectal Surveillance Culture of Vancomycin-Resistant Enterococci in Hospitalized Patients at Hematology-Oncology Unit / 감염과화학요법

ABSTRACT

BACKGROUND: Vancomycin-resistant enterococci (VRE) have emerged as important pathogens among hospitalized patients. We evaluated the prevalence of rectal VRE colonization at hematology-oncology unit and the correlation between VRE colonization and infection. MATERIALS & METHODS: All VRE isolates were obtained from rectal swabs and clinical samples of the patients hospitalized over 14-month period at hematology-oncology unit in St. Mary's Hospital. The agar screening test was performed by using 6 microgram/ml of vancomycin in brain heart infusion agar with 106 CFU inoculum. During this period, the environmental surveillance culture was performed in 4 hospital rooms. Species identification of VRE was done by Microscan and MICs to vancomycin. Identification and genotyping of VRE pattern were confirmed by multiplex PCR. RESULTS: Rectal colonization rate was 50.9% (230 among 452 patients). The most common isolate was E. faecium (72.4%) followed by E. faecalis (24.1%), and all had vanA genotype. Four VREs (three E. faecium and one E. faecalis) were isolated from 2 hospital rooms. During this period, 33 clinical VRE strains from 32 patients were isolated (infected or colonized). Twenty nine (90.6%) of these clinical isolates came from VRE carriers. CONCLUSION: This study showed a high rectal colonization rate of VRE in patients hospitalized at the hematology-oncology unit in St. Mary's Hospital. The colonization rate of VRE in the rectum was higher among the patients who had clinical infection by VRE. Therefore, the strategies for prevention and control of VRE infection should be deveoloped and monitored.