Surveillance and endemic vancomycin-resistant enterococci: some success in control is possible.

Hdl Handle:
http://hdl.handle.net/10147/126576
Title:
Surveillance and endemic vancomycin-resistant enterococci: some success in control is possible.
Authors:
Morris-Downes, M; Smyth, E G; Moore, J; Thomas, T; Fitzpatrick, F; Walsh, J; Caffrey, V; Morris, A; Foley, S; Humphreys, H
Affiliation:
Department of Microbiology, Beaumont Hospital, Dublin, Ireland.
Citation:
Surveillance and endemic vancomycin-resistant enterococci: some success in control is possible. 2010, 75 (3):228-33 J. Hosp. Infect.
Journal:
The Journal of hospital infection
Issue Date:
Jul-2010
URI:
http://hdl.handle.net/10147/126576
DOI:
10.1016/j.jhin.2010.01.004
PubMed ID:
20363048
Abstract:
Vancomycin-resistant enterococci (VRE) are prevalent in many Irish hospitals. We analysed surveillance data from 2001 to 2008 in a centre where VRE is endemic. All clinically significant enterococci were tested for susceptibility to vancomycin. All intensive care unit admissions were screened on admission and weekly thereafter. Interventions included isolating/cohorting VRE patients, monthly prevalence surveys of VRE patients, the introduction of an electronic alert system, programmes to improve hand and environmental hygiene, and the appointment of an antibiotic pharmacist. There was a significant increase in the number of positive VRE screening samples from 2001 (1.96 patients with positive VRE screens per 10 000 bed-days) to 2006 (4.98 per 10 000 bed-days) (P < or = 0.001) with a decrease in 2007 (3.18 per 10 000 bed-days) (P < or = 0.01). The number of VRE bloodstream infections (BSI) increased from 0.09 BSI per 10 000 bed-days in 2001 to 0.78 per 10 000 bed-days in 2005 (P < or = 0.001) but decreased subsequently. Linear regression analysis indicated a significant association between new cases of VRE and non-isolated VRE patients, especially between May 2005 and December 2006 [P=0.009; 95% confidence interval (CI): 0.08-0.46] and between May 2005 and December 2008 (P = 0.008; 95% CI: 0.06-0.46). Routine surveillance for VRE together with other measures can control VRE BSI and colonisation, even where VRE is endemic, and where facilities are constrained.
Item Type:
Article
Language:
en
MeSH:
Bacteremia; Carrier State; Cross Infection; Endemic Diseases; Enterococcus; Gram-Positive Bacterial Infections; Hospitals; Humans; Incidence; Infection Control; Ireland; Sentinel Surveillance; Vancomycin Resistance
ISSN:
1532-2939

Full metadata record

DC FieldValue Language
dc.contributor.authorMorris-Downes, Men
dc.contributor.authorSmyth, E Gen
dc.contributor.authorMoore, Jen
dc.contributor.authorThomas, Ten
dc.contributor.authorFitzpatrick, Fen
dc.contributor.authorWalsh, Jen
dc.contributor.authorCaffrey, Ven
dc.contributor.authorMorris, Aen
dc.contributor.authorFoley, Sen
dc.contributor.authorHumphreys, Hen
dc.date.accessioned2011-03-31T13:20:28Z-
dc.date.available2011-03-31T13:20:28Z-
dc.date.issued2010-07-
dc.identifier.citationSurveillance and endemic vancomycin-resistant enterococci: some success in control is possible. 2010, 75 (3):228-33 J. Hosp. Infect.en
dc.identifier.issn1532-2939-
dc.identifier.pmid20363048-
dc.identifier.doi10.1016/j.jhin.2010.01.004-
dc.identifier.urihttp://hdl.handle.net/10147/126576-
dc.description.abstractVancomycin-resistant enterococci (VRE) are prevalent in many Irish hospitals. We analysed surveillance data from 2001 to 2008 in a centre where VRE is endemic. All clinically significant enterococci were tested for susceptibility to vancomycin. All intensive care unit admissions were screened on admission and weekly thereafter. Interventions included isolating/cohorting VRE patients, monthly prevalence surveys of VRE patients, the introduction of an electronic alert system, programmes to improve hand and environmental hygiene, and the appointment of an antibiotic pharmacist. There was a significant increase in the number of positive VRE screening samples from 2001 (1.96 patients with positive VRE screens per 10 000 bed-days) to 2006 (4.98 per 10 000 bed-days) (P < or = 0.001) with a decrease in 2007 (3.18 per 10 000 bed-days) (P < or = 0.01). The number of VRE bloodstream infections (BSI) increased from 0.09 BSI per 10 000 bed-days in 2001 to 0.78 per 10 000 bed-days in 2005 (P < or = 0.001) but decreased subsequently. Linear regression analysis indicated a significant association between new cases of VRE and non-isolated VRE patients, especially between May 2005 and December 2006 [P=0.009; 95% confidence interval (CI): 0.08-0.46] and between May 2005 and December 2008 (P = 0.008; 95% CI: 0.06-0.46). Routine surveillance for VRE together with other measures can control VRE BSI and colonisation, even where VRE is endemic, and where facilities are constrained.-
dc.language.isoenen
dc.subject.meshBacteremia-
dc.subject.meshCarrier State-
dc.subject.meshCross Infection-
dc.subject.meshEndemic Diseases-
dc.subject.meshEnterococcus-
dc.subject.meshGram-Positive Bacterial Infections-
dc.subject.meshHospitals-
dc.subject.meshHumans-
dc.subject.meshIncidence-
dc.subject.meshInfection Control-
dc.subject.meshIreland-
dc.subject.meshSentinel Surveillance-
dc.subject.meshVancomycin Resistance-
dc.titleSurveillance and endemic vancomycin-resistant enterococci: some success in control is possible.en
dc.typeArticleen
dc.contributor.departmentDepartment of Microbiology, Beaumont Hospital, Dublin, Ireland.en
dc.identifier.journalThe Journal of hospital infectionen
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.