Is it time to revise linezolid doses in peritoneal dialysis patients? A case series.

12.8% in Greece and 7% in Israel; 27% acquired colonization during ICU stay occurred in the hospital in Israel. A low prevalence of CPE enteric carriage upon ICU admission was observed in this study, but important individual hospital variations in the incidence of ICU-acquired CPE were observed. Four hospitals (36%) had an incidence rate higher than 3%; in three of them nosocomial dissemination of CPE had been reported. – 11 In a recent study including 379 CPE from 45 Spanish hospitals, OXA-48 (71.5%) and VIM-1 (25.3%) were the most frequent carbapenemases and K. pneumoniae (74.4%), E. cloacae (10.3%) and E. coli (8.4%) were the species most affected. In that study, a wide inter-regional spread of CPE in Spain was observed, mainly due to a few successful clones of K. pneumoniae of ST11 and ST405, which mainly carried OXA-48, and ST15, which more often carried VIM. All of the 11 patients colonized by CPE were assigned to contact precautions, and the standard cross-transmission control measures were reinforced. In this regard, it is strongly advisable to implement the guidelines for the management of the infection control measures to reduce transmission of MDR Gram-negative bacteria recommended by ESCMID. Active targeted surveillance in combination with early implementation of infection control measures is needed in hospitals to prevent dissemination of CPE.