scholarly journals Vancomycin-resistant enterococci colonization and bacteremia in patients with hematological malignancies

2014 ◽  
Vol 8 (09) ◽  
pp. 1113-1118 ◽  
Author(s):  
Habip Gedik ◽  
Taner Yıldırmak ◽  
Funda Şimşek ◽  
Arzu Kantürk ◽  
Deniz Arıca ◽  
...  
Keyword(s):  
Hematological Malignancies ◽  
Tertiary Hospital ◽  
Control Measures ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Study Results ◽  
Hematological Cancers ◽  
Training And Research ◽  
The Mean ◽  
Vancomycin Resistant

Introduction: We retrospectively evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRE-related infections in patients with hematological malignancies. Methodology: All patients in the hematology department of the Ministry of Health Okmeydanı Training and Research Hospital, an 800-bed tertiary hospital in İstanbul, Turkey, older than 14 years of age and who developed febrile neutropenia during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated in this retrospective observational study. Results: A total of 282 neutropenic episodes in 126 patients who met the inclusion criteria were analyzed. The mean patient age was 51.73 ± 14.4 years (range: 17–82 years), and 66 cases occurred in male patients. The mean Multinational Association for Supportive Care in Cancer score of patients with hematological malignancies was 17.18 ± 8.27. Fifty (39.68%) patients were colonized with VRE, and the mean number of VRE colonization days per patient was 34.27 ± 13.12 days. Only two patients developed VRE bacteremia: a male patient with non-Hodgkin’s lymphoma who survived the infection, and a female patient with acute myeloid leukemia who died from VRE bacteremia. Conclusions: Patients with hematological malignancies accompanied by VRE colonization should be expected to develop VRE- or vancomycin-sensitive enterococci-related bacteremia under certain conditions, which include the development of severe mucositis, invasive procedures, and the use of intensive broad-spectrum antibiotics, even if infection control measures are implemented properly.

Control of Vancomycin-Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting

1999 ◽  
Vol 20 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Elise M. Jochimsen ◽  
Laurie Fish ◽  
Kelly Manning ◽  
Sally Young ◽  
Daniel A. Singer ◽  
...  
Keyword(s):  
Community Hospital ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Contact Isolation ◽  
Point Prevalence Survey ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
The Impact

AbstractObjective:To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.Design:To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point-prevalence survey was repeated 2 months after the cohort ward was established.Results:Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients,P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients,P=.002); and observed staff-patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions,P<.0001).Conclusions:Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.

Management of an Outbreak of Vancomycin-Resistant Enterococci in the Medical Intensive Care Unit of a Cancer Center

2001 ◽  
Vol 22 (4) ◽  
pp. 217-219 ◽  
Author(s):  
Hend Hanna ◽  
Jan Umphrey ◽  
Jeffrey Tarrand ◽  
Michelle Mendoza ◽  
Issam Raad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Control Measures ◽  
Cancer Center ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Medical Intensive Care ◽  
Vancomycin Resistant

AbstractBetween November 1996 and February 1997, 17 episodes of vancomycin-resistant enterococci (VRE) infection or colonization (9 infections, 8 colonizations), all with the same or a similar genomic DNA pattern, were identified in the medical intensive care unit (MICU) of a tertiary-care cancer hospital. The cases were genotypically traced to a patient who was admitted to the hospital in September 1996 and who, by December 1996, had four different admissions to the MICU. Multifaceted infection control measures, including decontamination of the environment and of nondisposable equipment, halted the nosocomial transmission of VRE in the MICU.

Infection-Control Measures Reduce Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

1999 ◽  
Vol 131 (4) ◽  
pp. 269 ◽  
Author(s):  
Marisa A. Montecalvo ◽  
William R. Jarvis ◽  
Jane Uman ◽  
David K. Shay ◽  
Coleen Petrullo ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Endemic Setting ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Vancomycin-Resistant Enterococci: The Value of Infection Control and Antibiotic Control Policy

2006 ◽  
Vol 17 (suppl b) ◽  
pp. 9B-12B ◽  
Author(s):  
Karl Weiss
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Health Care System ◽  
Control Measures ◽  
Canadian Health Care System ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Canadian Health ◽  
Canadian Health Care ◽  
Vancomycin Resistant

Vancomycin-resistant enterococci (VRE) represent a major challenge for the Canadian health care system. The clinical significance of VRE in the Canadian health care system has increased over the past two decades, with outbreaks reported in Ontario and Quebec, although most provinces have been affected. This organism has been a substantial human and financial burden for Canadian institutions. VRE have been shown to be associated with an increased mortality, a longer hospital stay and a much higher overall cost compared with vancomycinsusceptible strains. Enterococci are now the third most important nosocomial pathogen in American intensive care units. The two most common species,Enterococcus faecalisandEnterococcus faecium, have shown remarkable adaptability in responding to antibiotics. The arrival of VRE in Canada has forced hospitals to implement stringent and costly infection control measures. A multifaceted approach, including antibiotic restriction and stringent infection control measures, is important in managing VRE prevalence in Canadian institutions.

scholarly journals Risk Factors for Long-Term Vancomycin-Resistant Enterococci Persistence—A Prospective Longitudinal Study

2019 ◽  
Vol 7 (10) ◽  
pp. 400 ◽  
Author(s):  
Correa-Martinez ◽  
Stollenwerk ◽  
Kossow ◽  
Schaumburg ◽  
Mellmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Control ◽  
Control Measures ◽  
Factors Associated ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
History Of ◽  
Vancomycin Resistant ◽  
Prospective Longitudinal

Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens that require effective infection control measures, representing a challenge for healthcare systems. This study aimed at identifying risk factors associated with prolonged VRE carriage and determining the rate of clearance that allows the discontinuation of contact precautions. During a 2-year study, screening was performed in patients with a history of VRE or at risk of becoming colonized. After bacterial identification and antibiotic susceptibility testing, glycopeptide resistance was confirmed by PCR. Isolates were compared via whole genome sequence-based typing. Risk factors were recorded, and follow-up screening was performed upon readmission, defining patients as long-term carriers if still colonized ≥10 weeks after first detection. Of 1059 patients positive for VRE, carriage status was assessed upon readmission in 463 patients. VRE was cleared in 56.4% of the cases. Risk factors associated with long-term persistence were hospital stays (frequency, length), hemato-oncological disease, systemic treatment with steroids, and use of antibiotics. No specific genotypic clustering was observed in patients with VRE clearance or persistence. VRE clearance is possibly underestimated. The identification of risk factors favoring long-term carriage may contribute to a targeted implementation of infection control measures upon readmission of patients with history of VRE.

scholarly journals Evaluating hospital infection control measures for antimicrobial-resistant pathogens using stochastic transmission models: Application to vancomycin-resistant enterococci in intensive care units

2016 ◽  
Vol 27 (1) ◽  
pp. 269-285 ◽  
Author(s):  
Yinghui Wei ◽  
Theodore Kypraios ◽  
Philip D O’Neill ◽  
Susan S Huang ◽  
Sheryl L Rifas-Shiman ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Control Measures ◽  
Screening Tests ◽  
Patient Level ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Hospital Infection Control ◽  
Vancomycin Resistant ◽  
Precautionary Measures

Nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) are the cause of significant morbidity and mortality among hospital patients. It is important to be able to assess the efficacy of control measures using data on patient outcomes. In this paper, we describe methods for analysing such data using patient-level stochastic models which seek to describe the underlying unobserved process of transmission. The methods are applied to detailed longitudinal patient-level data on vancomycin-resistant Enterococci from a study in a US hospital with eight intensive care units (ICUs). The data comprise admission and discharge dates, dates and results of screening tests, and dates during which precautionary measures were in place for each patient during the study period. Results include estimates of the efficacy of the control measures, the proportion of unobserved patients colonized with vancomycin-resistant Enterococci, and the proportion of patients colonized on admission.

Control of Vancomycin-Resistant Enterococci in the Neonatal Intensive Care Unit

2005 ◽  
Vol 26 (7) ◽  
pp. 646-649 ◽  
Author(s):  
Nalini Singh ◽  
Marie-Michèle Léger ◽  
Joyce Campbell ◽  
Billie Short ◽  
Joseph M. Campos
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Dna Fingerprinting ◽  
Active Surveillance ◽  
Genetic Relatedness ◽  
Control Measures ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant

AbstractBackground and Objective:Multidrug-resistant organisms (MDROs), such as vancomycin-resistant enterococci (VRE), cause serious infections, especially among high-risk patients in NICUs. When VRE was introduced and transmitted in our NICU despite recommended infection control practices, we instituted active surveillance cultures to determine their efficacy in detecting and controlling spread of VRE among high-risk infants.Methods:Active surveillance cultures, other infection control measures, and a mandatory in-service education module on preventing MDRO transmission were implemented. Cultures were performed on NICU admission and then weekly during their stay. Molecular DNA fingerprinting of VRE isolates facilitated targeting efforts to eliminate clonal spread of VRE. Repetitive sequence PCR (rep-PCR)-based DNA fingerprinting was used to compare isolates recovered from patients with VRE infection or colonization. Environmental VRE cultures were performed around VRE-colonized or -infected patients. DNA fingerprints were prepared from the products of rep-PCR amplification and analyzed using software to determine strain genetic relatedness.Results:Active surveillance cultures identified 65 patients with VRE colonization or infection among 1,820 admitted to the NICU. Rep-PCR performed on 60 VRE isolates identified 3 clusters. Cluster 1 included isolates from 21 patients and 4 isolates from the environment of the index patient. Clusters 2 and 3 included isolates from 23 and 3 patients, respectively. Similarity coefficients among the members of each cluster were 95% or greater.Conclusions:Control of transmission of multi-clonal VRE strains was achieved. Active surveillance cultures, together with implementation of other infection control measures, combined with rep-PCR DNA fingerprinting were instrumental in controlling VRE transmission in our NICU. (Infect Control Hosp Epidemiol 2005;26:646-649)

Risk of Environmental and Healthcare Worker Contamination With Vancomycin-Resistant Enterococci During Outpatient Procedures and Hemodialysis

2006 ◽  
Vol 27 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Elizabeth A. Grabsch ◽  
Laurelle J. Burrell ◽  
Alexander Padiglione ◽  
Jason M. O'Keeffe ◽  
Susan Ballard ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Odds Ratio ◽  
Control Measures ◽  
University Teaching ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Outpatient Consultation ◽  
Hemodialysis Unit ◽  
Outpatient Procedures ◽  
Vancomycin Resistant

Objective.To assess the risk of environmental and healthcare worker (HCW) contamination with vancomycin-resistant enterococci (VRE) during outpatient procedures performed on fecally continent patients currently colonized with VRE (cVRE) or previously colonized with VRE (pVRE).Design.Observational study.Setting.Outpatient consultation and radiology rooms and the hemodialysis unit in a university teaching hospital.Patients.Fecally continent cVRE and pVRE patients.Interventions.Both cVRE and pVRE patients attended standardized mock outpatient consultations and routine hemodialysis sessions in an area that had been thoroughly cleaned and microbiologically confirmed to be free of VRE contamination. After each session, the patient, environment, and participating HCW were tested for VRE contamination.Results.Fourteen cVRE patients participated in 49 mock outpatient consultation sessions and radiology sessions or 26 actual hemodialysis sessions, and 7 pVRE patients participated in 28 outpatient consultation sessions. Sessions with cVRE patients had higher rates of contamination of the environment (chair cultures were positive for VRE in 36% of outpatient consultation sessions, 58% of hemodialysis sessions; couch cultures were positive in 48% of outpatient consultation sessions, 42% of radiology sessions, and 45% of hemodialysis sessions), contamination of HCW gowns (gown cultures were positive in 20% of outpatient consultation sessions, 4% of radiology sessions, and 30% of hemodialysis sessions), and contamination of patients' own hands (hand cultures were positive in 36% of outpatient consultation sessions, 25% of radiology sessions, and 54% of hemodialysis sessions). Overall, contamination rates associated with pVRE patients attendance at outpatient consultations were 12% of those noted for cVRE patients (odds ratio, 0.10; 95% confidence interval, 0.03-0.42;P= .001).Conclusions.Given the nature of the contamination risk posed by fecally continent cVRE patients undergoing outpatient procedures, infection control measures should focus on effective HCW and patient hand hygiene and chair and couch cleaning, to minimize transmission of VRE.

Lack of Transmission of Vancomycin-Resistant Enterococci in Three Long-Term–Care Facilities

1999 ◽  
Vol 20 (05) ◽  
pp. 341-343 ◽  
Author(s):  
Christina A. Greenaway ◽  
Mark A. Miller
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Point Prevalence ◽  
Control Measures ◽  
Term Care ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Care Facilities ◽  
Vancomycin Resistant

Abstract Three patients colonized with vancomycin-resistant Enterococcus were admitted to one or more of three long-term-care facilities. Six point-prevalence surveys revealed no transmission of vancomycin-resistant Enterococcus after a total of 234 days of exposure during which moderately strict infection control measures were implemented. Four of 116 environmental cultures were positive.

scholarly journals Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children’s Hospital in Germany 2015–2016

2016 ◽  
Vol 37 (11) ◽  
pp. 1310-1314 ◽  
Author(s):  
Tobias Tenenbaum ◽  
Klaus-Peter Becker ◽  
Bettina Lange ◽  
Anka Martin ◽  
Peter Schäfer ◽  
...  
Keyword(s):  
Chart Review ◽  
Treatment Strategies ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Multidrug Resistant Organisms ◽  
Clinical Diagnoses ◽  
Vancomycin Resistant ◽  
Current Screening

OBJECTIVETo determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany.DESIGNRetrospective observational study.SETTINGGeneral pediatric and pediatric surgery units.PATIENTSIn Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016.METHODSUsing electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees.RESULTSAmong 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycin-resistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate.CONCLUSIONImplementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted.Infect Control Hosp Epidemiol 2016;1–5

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