Evaluation of Patients Colonized with Vancomycin-resistant Enterococci Retrospectively Hospitalized in Pediatric Clinics During 2013-2014

Aim: Rectal VRE carriage has been investigated to reveal the situation in our hospital between 1 June 2013 and 1 Fabruary 2014 by periodically collected perirectal swabs from the hospitalized patients of pediatric services and intensive care units. Material and Method: Between 1 June 2013 and 1 Fabruary 2014, 139 children with VRE pozitivity were included. In our study The children were separated into four groups as Pediatric Service, Pediatric Hematology Service, Pediatric Intensive Care Unıt and Newborn Intensıve Care Unıt. The diagnosis, the day which the patient turned into VRE pozitivity, how long the patient was hospitalized, the drugs that the patient used were recorded. Findings: Rectal swabs were collected from all 1726 hospitalized patients. VRE colonization were determined in 139 (%8) patients. 54 (%4,5) among 1202 patients in Pediatric Service, 50 (% 19,5) among 257 patients in Pediatric Hematology, 24 (%43,5) among 55 patients in Pediatric Intensive Care Unit, 11 (%5) among 212 patients in Newborn Intensive Care Unit were VRE pozitive (especially high rate in Hematology and Pediatric Intensive Care Unit). 71 (%51) were male and 68 (%49) were female and average age was 5 years. Average hospitalization period was 55,2 days which is too long. It was 93,5 ,60 and 86,8 days respectively, in Pediatric Intensive Care, Hematology and in Newborn Intensive Care Unit. First Rectal VRE colonization was changing from the first day to 165. day of hospitalization (25th day on average). Mostly used antibiotics were meropenem, amikacin and vankomisin. Number of antibiotics that the patients used during hospitalization was 4.9, on average. Patients were mostly diagnosed as Leukemia and Chronic Renal Failure. 13 patients (%9,4) turned VRE negative during hospitalization. 14 patients were died (%10,1). Comparing the Pediatric Service with Hematology Service and Pediatric Intensive Care Unit, the number of antibiotics used and the hospitalization period was found statistically significant to predispose VRE colonization (respectively p<0,001 and p=0,002). Results: VRE is important nosocomial pathogen in the clinics where the patients have long-term treatment and the broad spectrum antibiotic use, espacially in Intensive Care Units and Hematology-Oncology services. For his reason, VRE surveillance is essential. For the patients in whom VRE has been detected, infection control and prevention must be done. Key Words: VRE, Pediatrics, Nosocomial