Acquisition of vancomycin-resistant enterococci in internal medicine wards

• 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
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2008.04.260

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.