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Efficacy of Percutaneous Abscess Drainage in Patients with Vancomycin-Resistant Enterococci

¹ Department of Radiology, White 270, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114.
² Present address: Istituto di Radiologia, Universitá degli Studi di Napoli "Federico II," II Policlinico, Via Pansini 5, 80131, Napoli, Italy.
³ Infectious Disease Division, Infection Control Unit, Jackson 504, Massachusetts General Hospital, Boston, MA 02114.

OBJECTIVE. We reviewed a 4-year experience draining fluid collections infected with vancomycin-resistant enterococci to determine the outcome of percutaneous intervention in patients with this highly resistant and increasingly common organism.

MATERIALS AND METHODS. Charts of patients from whom vancomycin-resistant enterococci had been isolated during percutaneous drainage were reviewed to determine patient response to drainage, catheter management, and outcome of treatment.

RESULTS. Twenty-one patients underwent percutaneous drainage of 28 fluid collections from which vancomycin-resistant enterococci were isolated, including 16 intraabdominal abscesses, seven biliary or urinary obstructions, and five empyemas. The drainage of 27 (96%) of 28 collections were technically successful. In seven patients, drainage provided the first isolation of vancomycin-resistant enterococci from the patient. Five patients also had blood cultures with positive findings for vancomycin-resistant enterococci, and 14 collections were coinfected with other bacteria or with fungi. Twenty collections (71%) or obstructions were successfully treated with percutaneous drainage. Drainage was unsuccessful in treating eight collections in seven patients.

CONCLUSION. Despite high-level antibiotic resistance, fluid collections infected with vancomycin-resistant enterococci can be successfully drained percutaneously, resulting in a favorable likelihood of recovery for patients.

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