Format

Send to

Choose Destination
BMC Infect Dis. 2014 Sep 23;14:514. doi: 10.1186/1471-2334-14-514.

Decolonization of gastrointestinal carriage of vancomycin-resistant Enterococcus faecium: case series and review of literature.

Author information

1
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China. kyyuen@hkucc.hku.hk.

Abstract

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.

PMID:
25248287
PMCID:
PMC4180964
DOI:
10.1186/1471-2334-14-514
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center