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Surgical Infection Society position on vancomycin-resistant Enterococcus
J M Davis1, M M Huycke, C L Wells
1Department of Surgery, Cornell University Medical College, New York, NY, USA.
Abstract:
The risk of transfer of vancomycin resistance to staphylococci is a real possibility and has been achieved in the laboratory. Prolonged colonization occurs with vancomycin-resistant Enterococcus (VRE), and many more patients are colonized than infected. The failure to identify, isolate, and adhere to infection control measures when caring for VRE-colonized patients dooms to failure any means to control its spread. Control of vancomycin use alone is unlikely to greatly affect the number of patients at risk for VRE colonization. The global spread of VRE may be impossible to stop, but infection control measures are the most important line of defense inside hospitals.
Insights
Vancomycin resistance transfer to staphylococci is possible. Strict infection control is crucial for managing vancomycin-resistant Enterococcus (VRE) spread, as limiting vancomycin use alone is insufficient.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Vancomycin resistance in Enterococcus (VRE) poses a significant healthcare challenge.
- Prolonged colonization with VRE is common, with more patients colonized than infected.
Purpose of the Study:
- To highlight the risk of vancomycin resistance transfer to staphylococci.
- To emphasize the critical role of infection control in managing VRE spread.
Main Methods:
- Laboratory studies demonstrating vancomycin resistance transfer.
- Clinical observations of VRE colonization and infection rates.
- Analysis of infection control measure effectiveness.
Main Results:
- Transfer of vancomycin resistance to staphylococci has been demonstrated in laboratory settings.
- Failure to implement and adhere to infection control protocols hinders VRE containment.
- Restricting vancomycin use alone is unlikely to significantly reduce VRE colonization risk.
Conclusions:
- Infection control measures are the primary defense against VRE spread within hospitals.
- The global spread of VRE may be challenging to halt entirely.
- Vigilant identification, isolation, and adherence to control measures are essential for VRE management.