Surveillance and endemic vancomycin-resistant enterococci: some success in control is possible.
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Authors
Morris-Downes, MSmyth, 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.Issue Date
2010-07MeSH
BacteremiaCarrier State
Cross Infection
Endemic Diseases
Enterococcus
Gram-Positive Bacterial Infections
Hospitals
Humans
Incidence
Infection Control
Ireland
Sentinel Surveillance
Vancomycin Resistance
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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 infectionDOI
10.1016/j.jhin.2010.01.004PubMed ID
20363048Abstract
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
ArticleLanguage
enISSN
1532-2939ae974a485f413a2113503eed53cd6c53
10.1016/j.jhin.2010.01.004
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