The epidemiology of vancomycin-resistant Enterococcus colonization in a medical intensive care unit.

نویسندگان

  • David K Warren
  • Marin H Kollef
  • Sondra M Seiler
  • Scott K Fridkin
  • Victoria J Fraser
چکیده

OBJECTIVE To determine the epidemiology of colonization with vancomycin-resistant Enterococcus (VRE) among intensive care unit (ICU) patients. DESIGN Ten-month prospective cohort study. SETTING A 19-bed medical ICU of a 1,440-bed teaching hospital. METHODS Patients admitted to the ICU had rectal swab cultures for VRE on admission and weekly thereafter. VRE-positive patients were cared for using contact precautions. Clinical data, including microbiology reports, were collected prospectively during the ICU stay. RESULTS Of 519 patients who had admission stool cultures, 127 (25%) had cultures that were positive for VRE. Risk factors for VRE colonization identified by multiple logistic regression analysis were hospital stay greater than 3 days prior to ICU admission (adjusted odds ratio [AOR], 3.6; 95% confidence interval [CI95], 2.3 to 5.7), chronic dialysis (AOR, 2.4; CI95, 1.2 to 4.5), and having been admitted to the study hospital one to two times (AOR, 2.3; CI95, 1.4 to 3.8) or more than two times (AOR, 6.5; CI95, 3.7 to 11.6) within the past 12 months. Of the 352 VRE-negative patients who had one or more follow-up cultures, 74 (21%) became VRE positive during their ICU stay (27 cases per 1,000 patient-ICU days). CONCLUSION The prevalence of VRE culture positivity on ICU admission was high and a sizable fraction of ICU patients became VRE positive during their ICU stay despite contact precautions for VRE-positive patients. This was likely due in large part to prior VRE exposures in the rest of the hospital where these control measures were not being used.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Co-infection or co-colonization with vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in a network of community hospitals.

To the Editor: The isolation of both methicillinresistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) from individual patients is ominous in light of the documented transfer of the vanA gene encoding vancomycin resistance from VRE to S. aureus. The article by Warren et al. in the February issue of Infection Control and Hospital Epidemiology described the epidemiolog...

متن کامل

Nasal and perirectal colonization of vancomycin sensitive and resistant enterococci in patients of paediatrics ICU (PICU) of tertiary health care facilities

BACKGROUND Enterococci normally inhabit the intestinal tract of humans and are also a potential pathogen in causing nosocomial infections. The increase in antibiotic resistance and transfer of antibiotic resistance gene to Staphylococcus aureus (S. aureus) due to co-colonization has increased its importance in research. The aim of the study was to evaluate local epidemiology of nasal and rectal...

متن کامل

Colonization with vancomycin-resistant enterococci (VRE) in intensive care unit patients in Cordoba City, Argentina.

The purpose of this study was to determine the prevalence of colonization with vancomycin-resistant enterococci (VRE) among intensive care unit (ICU) patients in a hospital in Córdoba, Argentina. We collected 235 rectal swab specimens from 147 ICU patients. Resistance to vancomycin was screened with the disk diffusion method, and MICs were determined with the E-test method. Vancomycin-resistant...

متن کامل

Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff t...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Infection control and hospital epidemiology

دوره 24 4  شماره 

صفحات  -

تاریخ انتشار 2003