Acquisition of vancomycin-resistant enterococci in internal medicine wards

Background Our institution experienced an increase in the frequency of vancomycin-resistant enterococci (VRE) clinical isolates, which rose 5-fold from 2004 to 2005. We sought to measure the prevalence of VRE carriage among medical inpatients in a tertiary hospital in Jerusalem and estimate the rate...

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Bibliographic Details
Published in:American journal of infection control 2009-03, Vol.37 (2), p.111-116
Main Authors: Cohen, Matan J, Adler, Amos, Block, Colin, Gross, Ilana, Minster, Naomi, Roval, Varda, Tchakirov, Rachel, Moses, Allon E, Benenson, Shmuel
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antibiotics
Biological and medical sciences
Carrier State - epidemiology
Carrier State - microbiology
Cross Infection - epidemiology
Cross Infection - microbiology
Cross-Sectional Studies
Disease transmission
Drug resistance
Enterococcus - isolation & purification
Epidemiology. Vaccinations
Feces - microbiology
Female
General aspects
Gram-Positive Bacterial Infections - epidemiology
Gram-Positive Bacterial Infections - microbiology
Hospitalization
Hospitals
Humans
Infection Control
Infectious Disease
Infectious diseases
Male
Medical sciences
Middle Aged
Perineum - microbiology
Prevalence
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Summary:Background Our institution experienced an increase in the frequency of vancomycin-resistant enterococci (VRE) clinical isolates, which rose 5-fold from 2004 to 2005. We sought to measure the prevalence of VRE carriage among medical inpatients in a tertiary hospital in Jerusalem and estimate the rate of acquisition during hospitalization. Methods During 2006, we performed 3 cross-sectional surveys, including 1039 patients, representing 3 phases of hospitalization: admission, hospital stay, and discharge. Perianal/stool samples were cultured for VRE. Results VRE carriage was 3.8% (95% confidence interval [CI] = 1.8% to 6.9%) on admission, 15% (95% CI = 9% to 23%) at discharge, and 32% (95% CI = 24% to 40%) among inpatients. Among inpatient carriers, 60% of the isolates represented a single strain. Recent previous hospitalization was the most significant predictor for identifying carriers on admission. Conclusions Our study demonstrates that substantial VRE transmission occurred during hospitalization. Identification of carriers on admission should supplement effective application of infection control methods in attempting to decrease VRE nosocomial spread and burden.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2008.04.260