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Control of endemic glycopeptide-resistant enterococci
L M Dembry1, K Uzokwe, M J Zervos
1Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
Infection Control and Hospital Epidemiology
|May 1, 1996
Summary
Control measures including barrier precautions and oral antibiotics effectively reduced vancomycin-resistant Enterococcus (VRE) in a renal unit. Eradicating VRE carriage in patients prevented further spread, demonstrating a successful strategy for infection control.
Area of Science:
- Infectious Diseases
- Epidemiology
- Clinical Microbiology
Background:
- Vancomycin-resistant Enterococcus (VRE) poses a significant challenge in healthcare settings, particularly in high-risk units like renal units.
- Understanding the epidemiology and effective control measures for VRE is crucial for preventing its spread and managing patient outcomes.
Purpose of the Study:
- To investigate the prevalence of VRE within a renal unit.
- To evaluate the effectiveness of implemented control strategies, including barrier precautions and targeted antimicrobial therapy, in managing VRE.
Main Methods:
- A 3-month prospective prevalence culture survey was conducted on a 24-bed renal unit in a 975-bed community teaching hospital.
- Patients with VRE were identified and matched with controls. Interventions included resistant-organism barrier precautions and oral doxycycline and rifampin for VRE stool colonization eradication in two patients.
Main Results:
- Seven patients with VRE (8 isolates) were identified, with Enterococcus faecium being the most common species.
- Successful eradication of VRE carriage was achieved in two patients treated with doxycycline and rifampin.
- No further VRE cases were identified during the final 30 days of the survey and at a 9-month follow-up.
Conclusions:
- Resistant-organism barrier precautions are essential for controlling VRE spread.
- Eliminating patient carriage of VRE, potentially through targeted antimicrobial therapy, can be a valuable component of VRE control strategies in endemic, low-prevalence settings.