Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-14T16:24:50.975Z Has data issue: false hasContentIssue false
  • English
  • Français

The Prevalence of Colonization With Vancomycin-Resistant Enterococcus at a Veterans' Affairs Institution

Published online by Cambridge University Press:  02 January 2015

Jerome I. Tokars ,
Sachiko Satake ,
David Rimland ,
Loretta Carson ,
Elaine R. Miller ,
Edna Killum ,
Ronda L. Sinkowitz-Cochran ,
Matthew J. Arduino ,
Fred C. Tenover  and
Barbara Marston
...Show all authors
Jerome I. Tokars*
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Sachiko Satake
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
David Rimland
Affiliation:
Medical Service, Veterans' Affairs Medical Center, Atlanta, Georgia
Loretta Carson
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Elaine R. Miller
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Edna Killum
Affiliation:
Medical Service, Veterans' Affairs Medical Center, Atlanta, Georgia
Ronda L. Sinkowitz-Cochran
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Matthew J. Arduino
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Fred C. Tenover
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Barbara Marston
Affiliation:
Medical Service, Veterans' Affairs Medical Center, Atlanta, Georgia
William R. Jarvis
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Hospital Infections Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-69, Atlanta, GA 30333
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To study vancomycin-resistant Enterococcus (VRE) prevalence, risk factors, and clustering among hospital inpatients.

Design:

Rectal-swab prevalence culture survey conducted from February 5 to March 22,1996.

Setting:

The Veterans' Affairs Medical Center, Atlanta, Georgia.

Patients:

Hospital (medical and surgical) inpatients.

Results:

The overall VRE prevalence was 29% (42/147 patients). The VRE prevalence was 52% (38/73 patients) among patients who had received at least one of six specific antimicrobials during the preceding 120 days, compared with only 5% (4/74) among those who had not received the antimicrobials (relative risk, 9.6; P <.001). The longer the period (up to 120 days) during which antimicrobial use was studied, the more closely VRE status was predicted. Among 67 hospital patients in 28 multibed rooms, clustering of VRE among current roommates was not found.

Conclusions:

At this hospital with relatively high VRE prevalence, VRE colonization was related to antibiotic use but not to roommate VRE status. In hospitals with a similar VRE epidemiology, obtaining cultures from roommates of VRE-positive patients may not be as efficient a strategy for identifying VRE-colonized patients as obtaining screening cultures from patients who have received antimicrobials.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 3 , March 1999 , pp. 171 - 175
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Livornese, L, Dias, S, Samel, C, Romanowski, R, Taylor, S, May, P, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.Google Scholar
2. Karanfil, L, Murphy, M, Josephson, A, Gaynes, R, Mandel, L, Hill, B, et al. A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195–200.Google Scholar
3. Boyce, J, Opal, S, Chow, J, Zervos, MJ, Potter-Bynoe, G, Sherman, C, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.CrossRefGoogle ScholarPubMed
4. Shay, DK, Maloney, SA, Montecalvo, M, Banerjee, S, Wormser, GP, Arduino, MJ, et al. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis 1995;172:993–1000.CrossRefGoogle ScholarPubMed
5. Centers for Disease Control and Prevention. Recommendations for preventing the spread of vancomycin resistance. MMWR 1995;44(RR-12):1–13.Google Scholar
6. Boyce, JM, Mermel, L, Zervos, MJ, Rice, L, Potter-Bynoe, G, Giorgio, C, et al. Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1995;16:634–637.Google Scholar
7. Satake, S, Clark, N, Rimland, D, Nolte, F, Tenover, F. Detection of vancomycin-resistant enterococci in fecal samples by PCR. J Clin Microbiol 1997;35:2325–2330.Google Scholar
8. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing. M100-S6. Wayne, PA: NCCLS; 1995.Google Scholar
9. Tenover, F, Arbeit, R, Goering, R, Mickelsen, PMB, Persing, D, Swaminathan, B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.Google Scholar
10. Armitage, P, Berry, G. Statistical Methods in Medical Research. 2nd ed. Oxford, England: Blackwell Scientific Publications; 1987:56–60.Google Scholar
11. Anglim, A, Byers, K, Anneski, C, Dill, J, Alexander, C, Dunai, D, et al. Risk factors for VRE colonization during an epidemic. Infect Control Hosp Epidemiol 1996;17(suppl):P18.Google Scholar
12. Montecalvo, M, de Lencastre, H, Carraher, M, Gedris, C, Chung, M, VanHorn, K, et al. Natural history of colonization with vancomycin-resistant Enterococcus faecium . Infect Control Hosp Epidemiol 1995;16: 680–685.Google Scholar
13. Muto, C, Karchmer, T, Cage, E, Durbin, L, Simonton, B, Farr, B. The utility of culturing roommates of patients with vancomycin resistant Enterococcus. Eighth Annual Meeting of the Society for Healthcare Epidemiology of America; Orlando, FL; April 1998. Abstract 76.Google Scholar
14. Landman, D, Quale, J, Oydna, E, Willey, B, Ditore, V, Zaman, M, et al. Comparison of five selective median for identifying fecal carriage of vancomycin-resistant enterococci. J Clin Microbiol 1996;34:751–752.Google Scholar
15. Bonilla, H, Zervos, M, Lyons, M, Bradley, S, Hedderwick, S, Ramsey, M, et al. Colonization with vancomycin-resistant Enterococcus faecium: comparisons of a long-term-care unit with an acute-care hospital. Infect Control Hosp Epidemiol 1997;18:333–339.Google Scholar
16. Morris, JG, Shay, DK, Hebden, JN, McCarter, RJ, Perdue, BE, Jarvis, WR, et al. Enterococci resistant to multiple antibiotic agents, including vancomycin. Ann Intern Med 1995;123:250–259.Google Scholar
17. Edmond, MB, Ober, J, Weinbaum, D, Pfaller, MA, Hwang, T, Sanford, M, et al. Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis 1995;20:1126–1133.CrossRefGoogle ScholarPubMed
18. Keita-Perse, O, Gaynes, R. Severity of illness scoring systems to adjust nosocomial infection rates: a review and commentary. Am J Infect Control 1996;24:429–434.Google Scholar
19. Knaus, W, Draper, E, Wagner, D, Zimmerman, J. APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818–825.Google Scholar
20. Strausbaugh, L, Atherton, S, Tjoelker, R. Vancomycin-resistant enterococci in a Veterans' Affairs nursing home care unit: a three-year perspective. Eighth Annual Meeting of the Society for Healthcare Epidemiology of America; Orlando, FL; April 1998. Abstract 68.Google Scholar
21. Trick, W, Kuehnert, M, Quirk, S, Arduino, M, Aguero, S, Jarvis, W. Point-prevalence survey and risk factors for inter-facility transmission of vancomycin-resistant enterococci (VRE) colonization among patients at acute and long-term care facilities in one community. Eighth Annual Meeting of the Society for Healthcare Epidemiology of America, Orlando, FL; April 1998. Abstract 70.Google Scholar