VRE

[valshingle]

My 20 yr old daughter cultured VRE (vancomycin resistant enterococci) from her last sinus surgery. She has not had any vancomycin given to her. The clinic and ID docs are not concerned and do not recommend any treatment. They are not concerned about her transmitting it to a non-CFer. She will be put in iso rooms from now on while in the hospital. She has not had to do this previously. The docs are also not concerned that her SA (staph. aureus) and PA (pseudomonas aureginosa) will convert to vanc resistant. Those two orginisms are already multiple drug resistant.
I am concerned that because this is most likely hospital acquired, the clinic docs might have a conflict of interest in handling it. My research on the web indicates that this is a potentially serious complication. According to what I read, it can be transmitted to a non-CF person, who could then become a carrier. I also read that it can give the PA and SA vancomycin resistance.
I do not know who to contact for more info, since her docs are not concerned. Any suggestions???

 

[valshingle]

My 20 yr old daughter cultured VRE (vancomycin resistant enterococci) from her last sinus surgery. She has not had any vancomycin given to her. The clinic and ID docs are not concerned and do not recommend any treatment. They are not concerned about her transmitting it to a non-CFer. She will be put in iso rooms from now on while in the hospital. She has not had to do this previously. The docs are also not concerned that her SA (staph. aureus) and PA (pseudomonas aureginosa) will convert to vanc resistant. Those two orginisms are already multiple drug resistant.
I am concerned that because this is most likely hospital acquired, the clinic docs might have a conflict of interest in handling it. My research on the web indicates that this is a potentially serious complication. According to what I read, it can be transmitted to a non-CF person, who could then become a carrier. I also read that it can give the PA and SA vancomycin resistance.
I do not know who to contact for more info, since her docs are not concerned. Any suggestions???

 

[LouLou]

Where are you located? I'd suggest you go to another nearby cf center for a second opinion. Treatment might not be best but I understand your conflict of interest concern.

 

[LouLou]

Where are you located? I'd suggest you go to another nearby cf center for a second opinion. Treatment might not be best but I understand your conflict of interest concern.

 

[TreasureGoddess]

I'd follow up with another center, and in the meantime, ask your center how they would treat SHOULD your daughter begin showing symptoms of this new infection. What would they do then? I've learned the hard way that each time my son's CF Center says, "Oh, we don't treat for that.....children don't show any symptoms of this.....it's just part of having CF....." we usually end up with my son having something colonized that coud've been irradicated should we have been more aggressive with treatment in the first place.
Keep asking questions online and with your docs. Find a nearby center, or make an appointment and take a trip to a center a few hours away, just keep asking questions. I'd want to know that if we DO decide to treat, what then? Not wait until something is happening and then they have to figure it out.
Good luck!

 

[TreasureGoddess]

I'd follow up with another center, and in the meantime, ask your center how they would treat SHOULD your daughter begin showing symptoms of this new infection. What would they do then? I've learned the hard way that each time my son's CF Center says, "Oh, we don't treat for that.....children don't show any symptoms of this.....it's just part of having CF....." we usually end up with my son having something colonized that coud've been irradicated should we have been more aggressive with treatment in the first place.
Keep asking questions online and with your docs. Find a nearby center, or make an appointment and take a trip to a center a few hours away, just keep asking questions. I'd want to know that if we DO decide to treat, what then? Not wait until something is happening and then they have to figure it out.
Good luck!

 

[valshingle]

We go to Cook Children's in Fort Worth. My daughter sees an adult CF doc while at college in Houston, TX. I'm trying to reach them now to see what they recommend. I will let you know what they suggest.

Thanks for responding!

 

[valshingle]

We go to Cook Children's in Fort Worth. My daughter sees an adult CF doc while at college in Houston, TX. I'm trying to reach them now to see what they recommend. I will let you know what they suggest.

Thanks for responding!

 

[thekidsarealright]

<img src="i/expressions/face-icon-small-sad.gif" border="0"> That was almost DEFINITLY hospital aquired if she just had a sinus surgery. MRSA and VRE are typically hospital aquired, but in recent years, MRSA has been seen more and more as a community aquired illness. We just discussed VRE yesterday in Pharmacology class. Enterococci are carried in the GI tract (any bacteria with enter- on the beginning usually means in the intestines). VRE means that this bacteria, enterococci, have "learned" how to get around vanco so that they can live even when vanco is present in the body. You don't have to have been on vancomycin to get VRE, it just means that vanco will not work on that bacteria. Pseudomonas and MRSA will remain the same. There is something called VRSA, or vancomycin resistant staphylococcus aureus, but it is aquired seperately. MRSA will not transform to VRSA.
You should DEFINITLY get a second opinion. VRE can be treated, but it can be tough for a physician to figure out the best route to go as far as antibiotics. You're right, there's a conflict of interest there. I'm going to talk to an instructor about it tomorrow and see what she says about it.

 

[thekidsarealright]

<img src="i/expressions/face-icon-small-sad.gif" border="0"> That was almost DEFINITLY hospital aquired if she just had a sinus surgery. MRSA and VRE are typically hospital aquired, but in recent years, MRSA has been seen more and more as a community aquired illness. We just discussed VRE yesterday in Pharmacology class. Enterococci are carried in the GI tract (any bacteria with enter- on the beginning usually means in the intestines). VRE means that this bacteria, enterococci, have "learned" how to get around vanco so that they can live even when vanco is present in the body. You don't have to have been on vancomycin to get VRE, it just means that vanco will not work on that bacteria. Pseudomonas and MRSA will remain the same. There is something called VRSA, or vancomycin resistant staphylococcus aureus, but it is aquired seperately. MRSA will not transform to VRSA.
You should DEFINITLY get a second opinion. VRE can be treated, but it can be tough for a physician to figure out the best route to go as far as antibiotics. You're right, there's a conflict of interest there. I'm going to talk to an instructor about it tomorrow and see what she says about it.