MAGNITUDE OF VANCOMYCIN RESISTANT ENTEROCOCCUS FECAL COLONIZATION AND BACTEREMIA IN PATIENTS WITH HEMATOLOGICAL DISEASES AT TERTIARY BONE MARROW TRANSPLANT CENTRE RAWALPINDI

Nargis Sabir; Luqman Satti; Abeera Ahmed; Gohar Zaman; Raheel Iftikhar; Nasir Ud Din

doi:10.51253/pafmj.v71i4.4768

Authors

Nargis Sabir Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Luqman Satti Pakistan Naval Ship Shifa Hospital, Karachi Pakistan
Abeera Ahmed Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Gohar Zaman Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Raheel Iftikhar Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Nasir Ud Din Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i4.4768

Keywords:

Antimicrobial susceptibility, Hematological diseases, Vancomycin resistant enterococci bacteremia, Vancomycin resistant enterococci colonization

Abstract

Objective: To discover the frequency of vancomycin resistant enterococci (VRE) fecal colonization and subsequent bacteremia in patients with hematological diseases in a bone marrow transplant center.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), in collaboration with Armed Forces Bone Marrow Transplant Center, Rawalpindi, from Jan 2016 to Dec 2019.

Methodology: Stool specimens/anal swabs from all enrolled patients were collected aseptically and transported to the laboratory without delay. Blood cultures were collected aseptically from only those enrolled patients who developed signs and symptoms of bacteremia. Stool and blood cultures were processed as per standard microbiological protocols. Enterococci were identified to species level by colony morphology and biochemical tests. Modified Kirby Bauer disc diffusion method and VITEK-2 system (Version-8.01 bio Merieux, France) were used to perform antimicrobial sensitivity of each isolate.

Results: A total number of 246 patients were studied. Among them, 67 (27%) patients had fecal colonization by vancomycin resistant enterococci. We report a statistically significant association of recent hospitalization, prolonged exposure to antimicrobial therapy, chemotherapy exposure and use of indwelling devices during the hospital stay with vancomycin resistant enterococci colonization. Vancomycin resistant enterococci bacteremia was detected in 57 (23%) patients. Among these 57 patients, 53 (93%) were vancomycin resistant enterococci colonizers. Vancomycin resistant enterococci colonization was significantly associated with vancomycin resistant enterococci bacteremia.

Conclusion: A considerable burden of vancomycin resistant enterococci fecal colonization exists among patients with hematological diseases. vancomycin resistant enterococci colonization poses a considerable risk of vancomycin........