Journal Article

Active Surveillance Reduces the Incidence of Vancomycin-Resistant Enterococcal Bacteremia

Connie S. Price, Suzanne Paule, Gary A. Noskin and Lance R. Peterson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 7, pages 921-928
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/377733
Active Surveillance Reduces the Incidence of Vancomycin-Resistant Enterococcal Bacteremia

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The impact of active surveillance of patients at risk for infection with vancomycin-resistant enterococci (VRE) was examined, and VRE bacteremia rates and the degree of VRE clonality in 2 similar neighboring hospitals were compared. Hospital A did not routinely screen patients for VRE rectal colonization; hospital B actively screened high-risk patients. Retrospective observations were made over the course of 6 years, beginning when initial VRE bloodstream isolates were recovered at each institution. The rate of VRE bacteremia was 2.1-fold higher at hospital A, and the majority of hospital A isolates were clonally related: 4 clones were responsible for infection in >75% of patients with VRE bacteremia, and isolates from 30% of patients were from the most common clone. The 4 most common clones at hospital B were responsible for infection in 37% of patients, and isolates from 14.5% of patients were from the most common clone. Lower VRE bacteremia rates and a more polyclonal population, representing less horizontal transmission, may result from routine screening of patients who are at risk for VRE and prompt contact isolation of colonized individuals.

Journal Article.  4189 words.  Illustrated.

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

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