Journal Article

Control of Endemic Vancomycin-Resistant <i>Enterococcus</i> among Inpatients at a University Hospital

David P. Calfee, Eve T. Giannetta, Lisa J. Durbin, Teresa P. Germanson and Barry M. Farr

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 3, pages 326-332
Published in print August 2003 | ISSN: 1058-4838
Published online August 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/376624
Control of Endemic Vancomycin-Resistant Enterococcus among Inpatients at a University Hospital

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We sought to determine the ability of surveillance cultures and isolation of vancomycin-resistant Enterococcus (VRE)–colonized patients to control nosocomial VRE infection and colonization during a 5-year period (November 1994 through October 1999). During this period, VRE colonization was limited to 0.82% of admissions. The incidence of VRE infection was 0.12 cases per 1000 patient-days (attack rate, 0.07%). Colonized patients were first identified by surveillance (95%) or routine clinical cultures (5%); 14% of colonized patients had a positive clinical culture a median of 15 days after a positive surveillance culture. Ten percent of colonized patients were identified by surveillance at the time of transfer from another health care facility. Identification of these colonized patients was associated with reduction from a peak incidence rate of 2.07% to a rate of 1.25% and stabilization at this lower level. The use of surveillance cultures to identify and isolate patients with asymptomatic colonization can provide sustained control of the spread of VRE within a health care facility.

Journal Article.  5269 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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