PMID: 8611357Feb 1, 1996Paper

Bacteremia in a pediatric hemodialysis unit secondary to Enterococcus fecalis

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
L C HymesH L Keyserling

Abstract

Bacteremia is often a serious and recurring problem in children with hemodialysis catheters. We report an outbreak of Enterococcus bacteremia in a pediatric hemodialysis unit occurring from June 1992 to June 1993. During this period, 18 episodes of bacteremia occurred in eight children; 11 infections were polymicrobial. Enterococcus fecalis was associated with 13 infections in five patients (8 polymicrobial). Other pathogens included Enterobacter cloacae (5 infections), Staphylococcus (3), Staphylococcus epidermidis (2), and Klebsiella pneumoniae (2). All Enterococcus infections occurred in patients with dual-lumen subclavian venous catheters. Skin and catheter sites were culture negative, except in one patient. Rectal swabs were positive for Enterococcus in five patients. Enterococcus was not isolated from any source within the unit. Serotypes of all Enterococcus isolates were different, except for 2 isolates in the same patient. Starting in June 1993, catheters were flushed after dialysis with vancomycin or ampicillin. Since initiating this procedure, further episodes of Enterococcus bacteremia have not occurred. A questionnaire sent to other pediatric hemodialysis units failed to identify Enterococcus among 26 cases of bacte...Continue Reading

References

Jan 1, 1989·American Journal of Nephrology·J AlmirallJ M Gatell
Oct 1, 1986·The Journal of Infectious Diseases·J S CheesbroughR P Burden
Aug 1, 1993·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·K J Sheth, K J Henrickson

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Sep 21, 2004·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Fabio PaglialongaNicola Principi
Aug 10, 2006·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ali Mirza OnderGaston Zilleruelo

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