Epidemiology of vancomycin-resistant Enterococcus faecium under a selective isolation policy at an urban county hospital

Lisa G. Winston, David R. Bangsberg, Henry F. Chambers, Sue C. Felt, Judith I. Rosen, Edwin D. Charlebois, Margaret Wong, Lynn Steele, Julie Louise Gerberding, Francoise Perdreau-Remington

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: We report our experience in a county hospital with the use of selective contact isolation for patients with vancomycin-resistant Enterococcus faecium (VREF). About 12% of patients with VREF are isolated for reasons such as draining wounds and uncontrolled diarrhea. Methods: Passive surveillance identified all inpatients (181) from 1995 to 1999 with cultures positive for VREF. Data were collected via electronic databases and from prospectively maintained infection control records. Isolates were typed with use of pulsed-field gel electrophoresis. Results: Nearly all patients (175/181) with VREF had been admitted at least 48 hours or had a history of previous hospitalization. Most patients (69%) had urine cultures positive for VREF without blood cultures positive for the organism. Only 12 of 127 (9.4%) patients with complete data had VREF infection on the basis of receiving treatment and/or having more than 1 blood culture positive for VREF. After VREF became endemic, statistically significant increased prevalence was not detected via surveillance of clinical cultures nor sequential point-prevalence studies. Two major genotypes carrying vanB resistance genes were identified and persisted throughout the period studied. VREF persisted in individual patients up to 46 months. Conclusions: The number of VREF infections in this facility has been low, despite appreciable colonization, for an extended period during which selective isolation was used.

Original languageEnglish (US)
Pages (from-to)400-406
Number of pages7
JournalAmerican Journal of Infection Control
Volume30
Issue number7
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Winston, L. G., Bangsberg, D. R., Chambers, H. F., Felt, S. C., Rosen, J. I., Charlebois, E. D., Wong, M., Steele, L., Gerberding, J. L., & Perdreau-Remington, F. (2002). Epidemiology of vancomycin-resistant Enterococcus faecium under a selective isolation policy at an urban county hospital. American Journal of Infection Control, 30(7), 400-406. https://doi.org/10.1067/mic.2002.122647