• Ivana Goić-Barišić, Marina Radić, Anita Novak, Žana Rubić, Nataša Boban, Boris Lukšić, and Marija Tonkić.
• 1Department of Clinical Microbiology, Split University Hospital Centre, Split, Croatia;2University of Split School of Medicine, Split, Croatia; 3Department of Clinical Epidemiology, Split University Hospital Centre, Split, Croatia; 4Department of Infectious Diseases, Split University Hospital Centre, Split, Croatia.
• Acta Clin Croat. 2020 Sep 1; 59 (3): 523-528.

AbstractVancomycin-resistant enterococci (VRE), especially Enterococcus faecium, have emerged as significant nosocomial pathogens and patients with impaired host defenses are at a particular risk of VRE infection. The most common occurrence is asymptomatic colonization of the gastrointestinal tract that can persist for a long time and serve as a reservoir for transmission of VRE to other patients. We present a case of a patient who was diagnosed with acute myelogenous leukemia and suffered from bone marrow aplasia following induction therapy. The patient received prolonged broad-spectrum antimicrobial therapy. During hospital stay, the patient developed Clostridium difficile infection (CDI) and was found to be colonized with a strain of Enterococcus faecium resistant to vancomycin during therapy for CDI. This case also highlights the role of risk factors that could contribute to development of resistance, particularly CDI. Early detection of VRE colonization or infection is a crucial component in hospital program designed to prevent transmission of nosocomial infections. Surveillance cultures of such patients should be mandatory.

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