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Vancomycin‐resistant enterococci: New threat in renal patients
Author(s) -
Trakarnvanich Thananda,
EiamOng Somchai
Publication year - 2000
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1046/j.1440-1797.2000.00009.x
Subject(s) - medicine , intensive care medicine , peritoneal dialysis , antibiotics , antimicrobial , vancomycin resistant enterococci , vancomycin , antibiotic resistance , infection control , vancomycin resistant enterococcus , peritonitis , microbiology and biotechnology , bacteria , genetics , biology , staphylococcus aureus
SUMMARY Vancomycin‐resistant enterococci (VRE) have been increasingly reported in current literature worldwide. The origin of the organisms remains speculative. Overuse of vancomycin and glycopeptide in animal feed for domestic animals may promote VRE proliferation. The contaminated food products may serve as a community reservoir for VRE. VRE could be found in virtually every environmental site as well as in the endogenous flora of the patients. Important risk factors of VRE infection comprise prolonged hospitalization and prior treatment with antibiotics including vancomycin. The modes of VRE transmission are still not clearly established but could be due to both direct: person‐to‐person and indirect transmissions. In renal patients, VRE infections have been mostly reported in continuous ambulatory peritoneal dialysis peritonitis. Some infections are also detected in haemodialysis patients as well as in renal transplantation patients. Selection of the definite antimicrobial treatment of VRE depends on the phenotypes of the resistance. Antimicrobial agents for VRE consist of the more conventional drugs, including chloramphenicol and tetracycline, and the newer ones, such as ramoplanin. Prevention and control of enteroccal infection should be emphasized in all hospitals and these could be successfully carried out by enhanced infection‐control strategies.