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

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    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.
    Issue Date
    2010-07
    MeSH
    Bacteremia
    Carrier State
    Cross Infection
    Endemic Diseases
    Enterococcus
    Gram-Positive Bacterial Infections
    Hospitals
    Humans
    Incidence
    Infection Control
    Ireland
    Sentinel Surveillance
    Vancomycin Resistance
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    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
    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
    ISSN
    1532-2939
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jhin.2010.01.004
    Scopus Count
    Collections
    Beaumont Hospital

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