Infection-control measures reduce transmission of vancomycin-resistant enterococci in an endemic setting

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Infection Control

Background:

• Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens in U.S. hospitals.
• VRE poses a substantial threat in healthcare settings, particularly in endemic environments.
• Effective strategies are needed to curb VRE transmission.

Purpose of the Study:

• To evaluate the impact of enhanced infection-control strategies on VRE transmission.
• To determine if intensified infection control measures can reduce VRE rates in an endemic setting.
• To assess changes in VRE infection and colonization rates.

Main Methods:

• Prospective cohort study conducted in an adult oncology inpatient unit.
• Implementation of enhanced infection-control strategies including cohorting, personal protective equipment use, patient education, and environmental surveillance.
• Comparison of outcomes between patients under enhanced strategies (n=259) and standard practices (n=184).

Main Results:

• Significant reduction in VRE bloodstream infection incidence (0.45 vs. 2.1 per 1000 patient-days; RR 0.22, P=0.04).
• Substantial decrease in VRE colonization rates (10.3 vs. 20.7 per 1000 patient-days; RR 0.5, P<0.001).
• Significant reduction in the use of most antimicrobial agents, with exceptions noted for clindamycin and amikacin.

Conclusions:

• Enhanced infection-control strategies are effective in reducing VRE transmission.
• These strategies led to a significant decrease in both VRE infections and colonization in an endemic oncology unit.
• The findings support the implementation of comprehensive infection control measures to combat VRE.