Decolonization of gastrointestinal carriage of vancomycin-resistant Enterococcus faecium : case series and review of literature
BACKGROUND: Prolonged asymptomatic carriage of vancomycin-resistant enterococci (VRE) in the gastrointestinal tract and the lack of effective decolonization regimen perpetuate the endemicity of VRE in the healthcare settings.
CASE PRESENTATION: We report a regimen for decolonization of gastrointestinal carriage of VRE by a combination of environmental disinfection, patient isolation, bowel preparation to wash-out the fecal bacterial population using polyethylene glycol, a five-day course of oral absorbable linezolid and non-absorbable daptomycin to suppress any remaining VRE, and subsequent oral Lactobacillus rhamnosus GG to maintain the colonization resistance in four patients, including two patients with end-stage liver cirrhosis, one patient with complication post liver transplant, and one patient with complicated infective endocarditis. All patients had clearance of VRE immediately after decolonization, and 3 of them remained VRE-free for 23 to 137 days of hospitalization, despite subsequent use of intravenous broad-spectrum antibiotics without anti-VRE activity.
CONCLUSION: This strategy should be further studied in settings of low VRE endemicity with limited isolation facilities.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
BMC infectious diseases - 14(2014) vom: 23. Sept., Seite 514 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cheng, Vincent C C [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 23.12.2014 Date Revised 21.10.2021 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/1471-2334-14-514 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM242150799 |
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| 100 | 1 | |a Cheng, Vincent C C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Decolonization of gastrointestinal carriage of vancomycin-resistant Enterococcus faecium |b case series and review of literature |
| 264 | 1 | |c 2014 | |
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| 500 | |a Date Completed 23.12.2014 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Prolonged asymptomatic carriage of vancomycin-resistant enterococci (VRE) in the gastrointestinal tract and the lack of effective decolonization regimen perpetuate the endemicity of VRE in the healthcare settings | ||
| 520 | |a CASE PRESENTATION: We report a regimen for decolonization of gastrointestinal carriage of VRE by a combination of environmental disinfection, patient isolation, bowel preparation to wash-out the fecal bacterial population using polyethylene glycol, a five-day course of oral absorbable linezolid and non-absorbable daptomycin to suppress any remaining VRE, and subsequent oral Lactobacillus rhamnosus GG to maintain the colonization resistance in four patients, including two patients with end-stage liver cirrhosis, one patient with complication post liver transplant, and one patient with complicated infective endocarditis. All patients had clearance of VRE immediately after decolonization, and 3 of them remained VRE-free for 23 to 137 days of hospitalization, despite subsequent use of intravenous broad-spectrum antibiotics without anti-VRE activity | ||
| 520 | |a CONCLUSION: This strategy should be further studied in settings of low VRE endemicity with limited isolation facilities | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a Chen, Jonathan H K |e verfasserin |4 aut | |
| 700 | 1 | |a Tai, Josepha W M |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Sally C Y |e verfasserin |4 aut | |
| 700 | 1 | |a Poon, Rosana W S |e verfasserin |4 aut | |
| 700 | 1 | |a Hung, Ivan F N |e verfasserin |4 aut | |
| 700 | 1 | |a To, Kelvin K W |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Jasper F W |e verfasserin |4 aut | |
| 700 | 1 | |a Ho, Pak-Leung |e verfasserin |4 aut | |
| 700 | 1 | |a Lo, Chung-Mau |e verfasserin |4 aut | |
| 700 | 1 | |a Yuen, Kwok-Yung |e verfasserin |4 aut | |
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