Vancomycin-resistant Enterococcus faecium in an Immunocompromised Patient

Over the last decades, Vancomycin-resistant Enterococcus, namely Enterococcus faecium, has emerged worldwide as a dreaded nosocomial pathogen, particularly in immunocompromised patients. Vancomycin-resistant Enterococcus infections remain rare but threatening, leading to high mortality rates, primarily because of limited treatment options.We once reported a case of nosocomial bacteremia caused by vancomycin-resistant Enterococcus faecium in a patient with acute myeloid leukemia. During his hospitalization for chemotherapy, the patient presented febrile neutropenic episodes, and his blood culture grew Enterococcus faecium that was resistant to vancomycin with a minimum inhibitory concentration > 256 mg/L by the E-test. The polymerase chaine reaction amplification revealed the presence of the VanA/VanB genes, and the resistance to both vancomycin and teicoplanin is consistent with the VanA phenotype. The patient died before starting appropriate antibiotic treatment.This case report highlights the importance of early diagnosis of Vancomycin-resistant Enterococcus infections, particularly in patients with impaired host defenses, in order to ensure a rapid infection management. It is the first case of Vancomycin-resistant Enterococcus reported in our microbiology laboratory. We also aim to emphasize the need of strict measures to control the spread of Vancomycin-resistant Enterococcus strains.