Enterococcal infections in children: Results of a 8 year study

Abstract

Objective: Enterococci have become a leading cause of nosocomial infection. These microorganisms are normal inhabitants of the human gastrointestinal tract. The aim of this study was to evaluate the enterococcal infection in children.Material and Methods: All patients with enterococcal infection between January 1, 2000 and December 31, 2007 were included in this study. Our study is a retrospective analysis of prospectively collected data. American Centers for Disease Control and Prevention criteria were used as standard definitions for nosocomial infections.Results: Enterococcus spp. infections were diagnosed in 164 of the 15.558 patients hospitalized in our center between January 1, 2000 and December 31, 2007 (overall incidence, 10.5 per 1,000 admissions). During the study period, a total of 209 Enterococcus spp. isolates were recovered from sterile body site cultures. Seventy-seven percent of enterococcal infections were nosocomial. The mean age of patients was 53.1 +/- 61.5 months (9 days-17 years) and 56% were male. The most common species of enterococci causing clinical infection were Enterococcus faecalis (55.5%), Enterococcus faecium (42.1%) and Enterococcus durans (2.4%). Most of the Enterococcus spp. (44.5%) were isolated from urine, followed by blood (19.5%), peritoneal fluid (14.6%), cerebrospinal fluid (12.1%) and catheter segment (4.8%). Vancomycin resistance was seen in 2.4 percent of Enterococcus spp., all of which were E. faecium. The most frequently seen enterococcal infections were urinary tract infections (32.3%), neonatal sepsis (22%), sepsis (14.6%), peritonitis (11.5%) and shunt meningitis (10.3%). Previous therapy with broad-spectrum antibiotics, underlying disease and prolonged hospitalization were commonly seen in patients with enterococcal infections. The mortality rate was found as 3.6% of all children with enterococcal infections.Conclusions: The two most common species of enterococci causing clinical infection were E. faecalis (55.5%) and E. faecium (42.1%). The most frequently enterococcal infections were urinary tract infections (32.3%), followed by neonatal sepsis (22%).