TY - JOUR
T1 - Epidemiology of vancomycin-resistant Enterococcus faecium under a selective isolation policy at an urban county hospital
AU - Winston, Lisa G.
AU - Bangsberg, David R.
AU - Chambers, Henry F.
AU - Felt, Sue C.
AU - Rosen, Judith I.
AU - Charlebois, Edwin D.
AU - Wong, Margaret
AU - Steele, Lynn
AU - Gerberding, Julie Louise
AU - Perdreau-Remington, Francoise
N1 - Funding Information:
Dr Winston is supported by the National Research Service Award T32 GM07546 from the National Institutes of Health. Dr Bangberg receives support from the Doris Duke Charitable Foundation. Dr Chambers receives support from United States Public Health Service grant number AI46610.
PY - 2002
Y1 - 2002
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0036846421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036846421&partnerID=8YFLogxK
U2 - 10.1067/mic.2002.122647
DO - 10.1067/mic.2002.122647
M3 - Article
C2 - 12410216
AN - SCOPUS:0036846421
SN - 0196-6553
VL - 30
SP - 400
EP - 406
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 7
ER -