Acta clinica Croatica, Vol. 59. No. 3., 2020.
Other
https://doi.org/10.20471/acc.2020.59.03.17
Vancomycin-Resistant Enterococcus faecium Colonization and Clostridium difficile Infection in a Hematologic Patient
Ivana Goić-Barišić
; Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia; University of Split School of Medicine, Split, Croatia
Marina Radić
; Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia; University of Split School of Medicine, Split, Croatia
Anita Novak
; Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia; University of Split School of Medicine, Split, Croatia
Žana Rubić
; Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia; University of Split School of Medicine, Split, Croatia
Nataša Boban
; University of Split School of Medicine, Split, Croatia; Department of Clinical Epidemiology, Split University Hospital Centre, Split, Croatia
Boris Lukšić
; University of Split School of Medicine, Split, Croatia; Department of Infectious Diseases, Split University Hospital Centre, Split, Croatia
Marija Tonkić
; Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia; University of Split School of Medicine, Split, Croatia
Abstract
Vancomycin-resistant enterococci (VRE), especially Enterococcus faecium, have emerged as significant nosocomial pathogens and patients with impaired host defenses are at a particular risk of VRE infection. The most common occurrence is asymptomatic colonization of the gastrointestinal tract that can persist for a long time and serve as a reservoir for transmission of VRE to other patients. We present a case of a patient who was diagnosed with acute myelogenous leukemia and suffered from bone marrow aplasia following induction therapy. The patient received prolonged broad-spectrum antimicrobial therapy. During hospital stay, the patient developed Clostridium difficile infection (CDI) and was found to be colonized with a strain of Enterococcus faecium resistant to vancomycin during therapy for CDI. This case also highlights the role of risk factors that could contribute to development of resistance, particularly CDI. Early detection of VRE colonization or infection is a crucial component in hospital program designed to prevent transmission of nosocomial infections. Surveillance cultures of such patients should be mandatory.
Keywords
Acute myelogenous leukemia; Clostridium difficile; Enterococcus faecium; Vancomycin-resistant enterococcus
Hrčak ID:
247507
URI
Publication date:
1.9.2020.
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