ÖZETEnterokoklar nozokomiyal enfeksiyonlarin önde gelen etkenleridir. Insanlarda gastrointestinal sistemin normal florasinda bulunurlar. Enterokoklar, endokardit, yara enfeksiyonu ve üriner sistem enfeksiyonu ile iliski olup, ayni zamanda nozokomiyal bakteriyemi etkenidir. Vankomisin dirençli enterokoklar (VRE) önemli bir nozokomiyal patojen olarak izole edilmektedir. Kinopristin-dalfopristin ve linezolid son zamanlarda VRE enfeksiyonlarinda kullanilan ajanlardir. Tigesiklin, daptomisin, ve diger gelistirilmekte olan antimikrobiyaller ile ilgili yeterli sayida klinik çalisma mevcut degildir. VRE’nin hastane içinde yayiliminin önlenmesi için yapilmasi gerekenler sirasiyla: vankomisinin akilci kullanimi, saglik personelinin egitilmesi, mikrobiyoloji laboratuarinin etkin kullanilmasi, enfeksiyon kontrol önlemlerine uyumun saglanmasidir. Anahtar kelimeler: Vankomisin-dirençli enterokok, enfeksiyon, çocukluk dönemi, tedavi.SUMMARY Enterococci have become a leading cause of nosocomial infection. These microorganisms are normal inhabitants of the human gastrointestinal tract. Classically associated with endocarditis, wound and urinary tract infections, increasingly they are a cause of nosocomial bacteremia. Vancomycin-resistant enterococci (VRE) have emerged as significant nosocomial pathogens. Quinupristin-dalfopristin and linezolid are among the anti-infective agents that have recently become available to treat infection caused by VRE. Preventing and controlling the spread of VRE will require coordinated, concerted efforts from all involved hospital departments and can be achived only if each of the follolwing elements is addressed: prudent vancomycin use, education of hospital personnel regarding the problem of vancomycin-resistance, effective use of the microbiology laboratory and implementation of infection control measures. Keywords: Vancomycin-Resistant enterococci, infection, children, treatment
VRE’dan korunma ve kontrol yöntemleri
Enterokoklarin hastadan hastaya direkt transferinin, veya indirekt olarak kontamine eller, kontamine yüzeyler ya da tibbi cihazlar yoluyla transferinin mümkün oldugu da gösterilmistir. VRE yayiliminin önlenmesi amaciyla rehberler gelistirilmistir. Hospital Infection Control Practices Advisory Committee (HICPAC) önerileri günümüzde en fazla kabul görmektedir (51). Uygun vankomisin kullanimi, hastane personelinin egitimi, mikrobiyoloji laboratuarinin etkin kullanimi, kontrol önlemlerinin uygulanmasi olarak özetlenebilir.
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