Evaluation of Vancomycin-Resistant Enterococci (VRE)–Associated Morbidity Following Relaxation of VRE Screening and Isolation Precautions in a Tertiary Care Hospital

2014 ◽  
Vol 35 (7) ◽  
pp. 818-825 ◽  
Author(s):  
Kristin Y. Popiel ◽  
Mark A. Miller
Keyword(s):  
Tertiary Care ◽  
Hospital Setting ◽  
Care Hospital ◽  
Marked Rise ◽  
Infection Incidence ◽  
Vancomycin Resistant Enterococci ◽  
Emergency Room Patients ◽  
Targeted Screening ◽  
Before And After ◽  
Vancomycin Resistant

ObjectiveTo determine whether relaxing vancomycin-resistant enterococci (VRE) precautions results in an increase in the incidence of invasive VRE infections over time.DesignRetrospective analysis of a microbiology database before and after relaxation of VRE screening and isolation precautions.SettingUrban tertiary care teaching hospital in Montreal, Canada.Participants.All hospitalized and emergency room patients over a 13-year period from January 1, 2000, to March 31, 2013.MethodsWe assessed the results of all microbiology cultures for the presence of VRE as well as the results of all polymerase chain reaction assays forvanAandvanBduring the study period. Applying criteria for 4 clinical situations (bacteremia, definite infection, possible infection, and colonization with VRE), we analyzed the effects of relaxed VRE screening and isolation precautions on the incidence of each of these outcomes over the time preceding and following this change.ResultsWhen VRE screening and isolation precautions were relaxed, a marked rise in VRE colonization was observed, with a lesser but definite rise in the 3 other outcomes. Despite this initial rise in all measures, all incidences other than colonization plateaued during the 34 months of follow-up.ConclusionsRelaxation of VRE screening and isolation precautions was associated with an immediate increase in colonization and infection incidence. Despite increasing colonization, infection outcomes remained infrequent and stable, suggesting a finite number of susceptible hosts at risk. Relaxation of VRE protocols may not lead to increasing infection incidence in a hospital setting, advocating that cost effectiveness exercises, with targeted screening and isolation precautions, are crucial.

Prevalence of Vancomycin Resistant Enterococci in Various Clinical Specimens in Tertiary Care Hospital in North Delhi

2012 ◽  
Vol 3 (3) ◽  
pp. 141-144
Author(s):  
Swati Chaudhary ◽  
◽  
Swastika Aggarwal ◽  
Pawan Kumar ◽  
SK Aggarwal SK Aggarwal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junko Kohno ◽  
Tsuyoshi Kawamura ◽  
Akiko Kikuchi ◽  
Tetsuya Akaishi ◽  
Shin Takayama ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care ◽  
Albumin Level ◽  
Kampo Medicine ◽  
Care Hospital ◽  
Intestinal Immunity ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Japanese Traditional Medicine ◽  
Negative Conversion

AbstractVancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

scholarly journals A descriptive study of vancomycin resistant enterococci in Tertiary Care Hospital of Western India

2020 ◽  
Vol 7 (3) ◽  
pp. 230-236
Author(s):  
Ridhdhi B Patel ◽  
◽  
Geeta M Vaghela ◽  
Manali Shah ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Western India ◽  
Care Hospital ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

PREVALENCE OF HIGH LEVEL AMINOGLYCOSIDE RESISTANCE AND VANCOMYCIN RESISTANT ENTEROCOCCI IN ENTEROCOCCAL ISOLATES IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 3-5
Author(s):  
Sunita Agarwal ◽  
Nazneen Pathan ◽  
Shivra Batra ◽  
Rajni Sharma
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Automated System ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Aminoglycoside Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

Introduction: The emergence of High Level Aminoglycoside Resistance (Resistant to Gentamycin and Streptomycin) and Vancomycin Resistant Enterococci among Indoor and Intensive Care Unit admitted patient presents a serious challenge for clinicians. Objective: To determine Enterococcal burden in blood and urine specimens and to detect the prevalence of High Level Aminoglycoside Resistance and Vancomycin Resistant Enterococci. Material & Methods: One hundred ten Enterococci were isolated from blood and urine samples and processed according to standard laboratory protocol. Species identication and sensitivity was done using the VITEK 2 automated system (Biomerieux France) with the cards GPID and AST 67 respectively. Results: Out of 110 Enterococci isolates, 36 were from blood and 74 from urine were detected. Different Species isolated were Enterococcal faecium (59%), Enterococcal faecalis (34%), Enterococcal rafnosus (2.7%), Enterococcal gallinarum (1.8%), Enterococcal casseliavus (0.9%) and Enterococcal duran (0.9%).Out of 36 blood isolates, 14 (38%) were found to be both High Level Gentamycin Resistant (HLGR) & High Level Streptomycin Resistant (HLSR), 10 (27%) were only HLGR and 8 (22%) were only HLSR. 20 strain (55%) of Enterococcus species isolated in blood were VRE. All VRE strains were found to be resistant to both aminoglycosides ( HLAR).Among the 74 urinary isolates, 24 (34%) were found to be both HLGR & HLSR, only HLGR was observed in 20 (27%) and HLSR was observed in 11 (14%) isolates. 24 strains (34%) of Enterococcus species were found to be vancomycin resistant in urine. 23 strains out of 24 were resistant to high level of aminoglycosides. Conclusion: The prevalence of HLAR and VRE is very high among Enterococcus specimens from indoor/ intensive care unit patients. Early species identication and antibiotic sensitivity result can help in better clinical outcome.

scholarly journals Decontamination of Targeted Pathogens from Patient Rooms Using an Automated Ultraviolet-C-Emitting Device

2013 ◽  
Vol 34 (5) ◽  
pp. 466-471 ◽  
Author(s):  
Deverick J. Anderson ◽  
Maria F. Gergen ◽  
Emily Smathers ◽  
Daniel J. Sexton ◽  
Luke F. Chen ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Environmental Services ◽  
Convenience Sample ◽  
Vancomycin Resistant Enterococci ◽  
Colony Forming Units ◽  
Before And After ◽  
Ultraviolet C ◽  
Vancomycin Resistant ◽  
Tertiary Care Hospitals ◽  
Uv C

Objective.To determine the effectiveness of an automated ultraviolet-C (UV-C) emitter against vancomycin-resistant enterococci (VRE),Clostridium difficile, andAcinetobacterspp. in patient rooms.Design.Prospective cohort study.Setting.Two tertiary care hospitals.Participants.Convenience sample of 39 patient rooms from which a patient infected or colonized with 1 of the 3 targeted pathogens had been discharged.Intervention.Environmental sites were cultured before and after use of an automated UV-C-emitting device in targeted rooms but before standard terminal room disinfection by environmental services.Results.In total, 142 samples were obtained from 27 rooms of patients who were colonized or infected with VRE, 77 samples were obtained from 10 rooms of patients withC. difficileinfection, and 10 samples were obtained from 2 rooms of patients with infections due toAcinetobacter. Use of an automated UV-C-emitting device led to a significant decrease in the total number of colony-forming units (CFUs) of any type of organism (1.07 log10reduction;P< .0001), CFUs of target pathogens (1.35 log10reduction;P< .0001), VRE CFUs (1.68 log10reduction;P< .0001), and C.difficileCFUs (1.16 log10reduction;P< .0001). CFUs ofAcinetobacteralso decreased (1.71 log10reduction), but the trend was not statistically significantP= .25). CFUs were reduced at all 9 of the environmental sites tested. Reductions similarly occurred in direct and indirect line of sight.Conclusions.Our data confirm that automated UV-C-emitting devices can decrease the bioburden of important pathogens in real-world settings such as hospital rooms.

scholarly journals Assessing the intestinal carriage rates of vancomycin-resistant enterococci (VRE) at a tertiary care hospital in Hungary

2019 ◽  
Vol 65 (3) ◽  
pp. 483-490
Author(s):  
Dorottya Franyó ◽  
Balázs Kocsi ◽  
Evelin Erzsébet Bukta ◽  
Judit Szabó ◽  
Zsuzsanna Dombrádi
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Multiresistant Pathogens ◽  
Carriage Rate ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Broth Enrichment

Abstract Excessive use of antibiotics contributes to the selection of resistant bacteria and intestinal colonization with multiresistant pathogens poses a risk factor for subsequent infections. The present study assessed vancomycin-resistant enterococci (VRE) carriage rates in patients admitted to our tertiary care hospital. Stool samples sent for routine culturing were screened with vancomycin containing solid or broth enrichment media. VRE isolates were identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and antibiotic susceptibilities were tested by E-test. Vancomycin resistance genes were detected by polymerase chain reaction. Medical records of carriers were examined for suspected risk factors for colonization. Altogether 3025 stool specimens were analyzed. Solid media identified a VRE carriage rate of 2.2% while broth enrichment detected 5.8%. Seventy percent of the isolates were Enterococcus faecium. VanB genotype was detected in 38.2%, VanA in 37.3%, VanC1 in 22.6%, and VanC2 in 1.9%. All VRE were sensitive to linezolid, daptomycin, and tigecycline. Collective risk factors for carriage were diabetes, normal flora absence, Clostridioides difficile positivity, longer hospital stay, and advanced age. 78.5% of the carriers received antibiotic therapy which was metronidazole in most cases (47.3%). We recommend regular screening of risk groups such as patients with diabetes, history of recent hospitalization, or former C. difficile infection as an imperative step for preventing VRE dissemination.

scholarly journals Molecular epidemiology of vancomycin-resistant Enterococcus faecium clinical isolates in a tertiary care hospital in southern Thailand: a retrospective study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11478
Author(s):  
Phanvasri Saengsuwan ◽  
Kamonnut Singkhamanan ◽  
Siribhorn Madla ◽  
Natnicha Ingviya ◽  
Chonticha Romyasamit
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Molecular Techniques ◽  
Diffusion Method ◽  
Care Hospital ◽  
Drug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Peritoneal Dialysis Fluid ◽  
Southern Thailand ◽  
Vancomycin Resistant

Objective Vancomycin-resistant enterococci are nosocomial pathogens that are responsible for commonly causing healthcare-associated infections, and they exhibit increased resistance to many antimicrobials, particularly to vancomycin. The epidemiological data available on vancomycin-resistant enterococci (VRE) in Thailand are inadequate. Methods Using enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), this study investigated genes that encode antimicrobial resistance and genetic relatedness to further understand VRE prevalence. Ninety VRE isolates were collected between 2011 and 2019 from a tertiary care hospital in southern Thailand. Antimicrobial susceptibility was determined using the disk diffusion method and E-test methods. Multiplex PCR was performed to detect the van gene and virulence genes. Results The study showed a high prevalence of diverse multidrug-resistant VRE strains. The prevalence of VRE infection was the highest in 2014 (28 isolates, 39.4%). VRE were mostly found in the urogenital tract (26 isolates, 28.9%), followed by the digestive tract (20%), body fluid, i.e., pancreatic cyst fluid, peritoneal dialysis fluid, Jackson–Pratt (JP) drain (20%), and blood specimens (10%). Patients in medical and surgical wards had 71.1% multi-drug-resistant and 28.9% extensively drug-resistant (XDR) VRE strains, respectively. The most prevalent antibiotic resistance was to ampicillin (74.4%). Susceptibility to gentamicin and meropenem were similar (7% and 10%, respectively). Four isolates (4.4%) were resistant to colistin. Only vanA was detected among the strains. The virulence gene test showed that the detection rates of enterococcal surface protein (esp) and hyaluronidase (hyl) genes were 91.1% and 5.6%, respectively. According to ERIC-PCR analysis, 51 of 90 strains had clonality, with a similarity rate of 95%. Conclusions We conclude that there is a need to implement infection control practices and active surveillance. Molecular techniques can effectively detect antibiotic-resistant genes, which would allow monitoring to control VRE infection in hospitals.

scholarly journals Increasing Trend of Vancomycin-resistant Enterococci Bacteremia in a Tertiary Care Hospital, South India: A Three-year Prospective Study

2021 ◽  
Vol 25 (8) ◽  
pp. 882-886
Author(s):  
Anitha Gunalan ◽  
Monika Sivaradjy ◽  
Ketan Priyadarshi ◽  
Haritha Madigubba ◽  
Deepashree Rajshekar ◽  
...  
Keyword(s):  
Prospective Study ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Vancomycin Resistant Enterococci ◽  
Increasing Trend ◽  
Vancomycin Resistant
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