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Open Access Research article

Prevalence of vancomycin-resistant Enterococcus fecal colonization among kidney transplant patients

Maria Cecília S Freitas14*, Alvaro Pacheco-Silva14, Dulce Barbosa14, Suzane Silbert124, Hélio Sader24, Ricardo Sesso14 and Luis Fernando A Camargo34

Author Affiliations

1 Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo (UNIFESP), Hospital do Rim e Hipertensão, Brazil

2 Special Clinical Microbiology Laboratory (LEMC), Division of Infectious Diseases-UNIFESP, Brazil

3 Infectious Diseases Unit, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, Brazil

4 Department of Medicine, Division of Nephrology and Infectious Diseases, Universidade Federal de São Paulo, Hospital do Rim e Hipertensão, SP, Brazil

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BMC Infectious Diseases 2006, 6:133  doi:10.1186/1471-2334-6-133

Published: 22 August 2006

Abstract

Background

End stage renal disease patients are at risk of Vancomycin-Resistant Enterococcus (VRE) infections. The first reports of VRE isolation were from hemodialysis patients. However, to date, VRE fecal colonization rates as well as associated risk factors in kidney transplant patients have not yet been established in prospective studies.

Methods

We collected one or two stool samples from 280 kidney transplant patients and analysed the prevalence of VRE and its associated risk factors. Patients were evaluated according to the post-transplant period: group 1, less than 30 days after transplantation (102 patients), group 2, one to 6 months after transplantation (73 patients) and group 3, more than 6 months after transplantation (105 patients).

Results

The overall prevalence rate of fecal VRE colonization was 13.6% (38/280), respectively 13.7% for Group 1, 15.1% for group 2 and 12.4% for group 3. E. faecium and E. faecalis comprised 50% of all VRE isolates. No immunologic variables were clearly correlated with VRE colonization and no infections related to VRE colonization were reported.

Conclusion

Fecal VRE colonization rates in kidney transplant patients were as high as those reported for other high-risk groups, such as critical care and hemodialysis patients. This high rate of VRE colonization observed in kidney transplant recipients may have clinical relevance in infectious complications.