Prevalence studies of vancomycin-resistant enterococci for monitoring a passive surveillance program in a pediatric hospital

2006 ◽  
Vol 1289 ◽  
pp. 107-110
Author(s):  
H. Lopardo ◽  
A. Corso ◽  
P. Gagetti ◽  
M. Carbonaro ◽  
E. Andión ◽  
...  
Keyword(s):  
Surveillance Program ◽  
Passive Surveillance ◽  
Pediatric Hospital ◽  
Prevalence Studies ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Impact of Surveillance for Vancomycin-Resistant Enterococci on Controlling a Bloodstream Outbreak Among Patients With Hematologic Malignancy

2004 ◽  
Vol 25 (5) ◽  
pp. 391-394 ◽  
Author(s):  
Ray Hachem ◽  
Linda Graviss ◽  
Hend Hanna ◽  
Rebecca Arbuckle ◽  
Tanya Dvorak ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hematologic Malignancy ◽  
Incidence Density ◽  
Fiscal Year ◽  
Surveillance Program ◽  
Complete Control ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant ◽  
The Impact

AbstractObjective:To determine the impact of stool surveillance cultures of critically ill patients on controlling vancomycin-resistant enterococci (VRE) outbreak bacteremia.Design:Stool surveillance cultures were performed on patients who had hematologic malignancy or were critically ill at the time of hospital admission to identify those colonized with VRE. Hence, contact isolation was initiated.Setting:A tertiary-care cancer center with a high prevalence of VRE.Participants:All patients with hematologic malignancy who were admitted to the hospital as well as all of those admitted to the intensive care unit were eligible.Results:Active stool surveillance cultures performed between 1997 and 2001 decreased the incidence density of VRE bacteremias eightfold while vancomycin use remained constant. In fiscal year (FY) 1997 and FY 1998, there were five and three VRE outbreak bacteremias, respectively. The outbreak clones were responsible for infection in 69% of those patients with VRE bacteremia. However, the stool surveillance program resulted in the complete control of VRE bacteremia by FY 1999 until the end of the study.Conclusion:Despite the steady use of vancomycin, the active surveillance program among high-risk patients with hematologic malignancy and those who were critically ill resulted in the complete control of VRE outbreak bacteremia at our institution.

scholarly journals Rapid detection of Van genes in rectal swabs by real time PCR in Southern Brazil

2011 ◽  
Vol 44 (5) ◽  
pp. 631-632
Author(s):  
Vlademir Cantarelli ◽  
Bianca Cavalcante ◽  
Diogo André Pilger ◽  
Fabiana Souza ◽  
Cícero Gomes Dias ◽  
...  
Keyword(s):  
Real Time ◽  
Rapid Detection ◽  
Surveillance Program ◽  
Southern Brazil ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Polymerase Chain ◽  
Low Sensitivity

INTRODUCTION: Laboratory-based surveillance is an important component in the control of vancomycin resistant enterococci (VRE). METHODS: The study aimed to evaluate real-time polymerase chain reaction (RT-PCR) (genes vanA-vanB) for VRE detection on 115 swabs from patients included in a surveillance program. RESULTS: Sensitivity of RT-PCR was similar to primary culture (75% and 79.5%, respectively) when compared to broth enriched culture, whereas specificity was 83.1%. CONCLUSIONS: RT-PCR provides same day results, however it showed low sensitivity for VRE detection.

Vancomycin-Resistant Enterococci in Canada: Results from the Canadian Nosocomial Infection Surveillance Program, 1999–2005

2008 ◽  
Vol 29 (3) ◽  
pp. 271-274 ◽  
Author(s):  
Marianna Ofner-Agostini ◽  
B. Lynn Johnston ◽  
Andrew E. Simor ◽  
John Embil ◽  
Anne Matlow ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Incidence Rate ◽  
Surveillance Program ◽  
Vancomycin Resistant Enterococci ◽  
Infection Surveillance ◽  
Vancomycin Resistant

Surveillance for vancomycin-resistant enterococci (VRE) in sentinel Canadian hospitals has been conducted since 1999. From 1999 to 2005, the rate of VRE detection increased from 0.37 to 1.32 cases per 1,000 patients admitted, and the rate of VRE infection increased from 0.02 to 0.05 cases per 1,000 patients admitted. Thirty-three percent of all patients with VRE detected that were reported during 1999-2005 were identified in 2005, with increases seen in all regions of Canada. Although the incidence rate of VRE carriage in Canada is increasing, it remains very low.

Epidemiology of Vancomycin-Resistant Enterococci Among Patients on an Adult Stem Cell Transplant Unit: Observations From an Active Surveillance Program

2008 ◽  
Vol 29 (11) ◽  
pp. 1019-1025 ◽  
Author(s):  
Michael S. Calderwood ◽  
Andreas Mauer ◽  
Jocelyn Tolentino ◽  
Ernesto Flores ◽  
Koen van Besien ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Stem Cell ◽  
Active Surveillance ◽  
Stem Cell Transplant ◽  
Surveillance Program ◽  
Cell Transplant ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Active Surveillance Program

Objective.To use the findings of an active surveillance program to delineate the unique epidemiology of vancomycin-resistant enterococci (VRE) in a mixed population of transplant and nontransplant patients hospitalized on a single patient care unit.Design.Surveillance survey and case-control analysis.Setting.A 19-bed adult bone marrow and stem cell transplant unit at a referral and primary-care center.Patients.The study included patients undergoing transplantation, patients who had previously received bone marrow or stem cell transplants, and patients with other malignancies and hematological disorders who were admitted to the study unit.Methods.Patients not previously identified as colonized with VRE had perirectal swab specimens collected at admission and once weekly while hospitalized on the unit. The prevalence of VRE colonization at admission and the incidence throughout the hospital stay, genotypes of VRE specimens as determined by pulsed field gel electrophoresis, and risk factors related to colonization were analyzed.Results.There was no significant difference in the prevalence or incidence of new colonization between nontransplant patients and prior or current transplant recipients, although overall prevalence at admission was significantly higher in the prior transplant group. Preliminary genotypic analysis of VRE isolates from transplant patients suggests that a proportion of cases of newly detected VRE carriage may represent prior colonization not detected at admission, with different risk factors suggestive of a potential epidemiological distinction.Conclusion.Examination of epidemiological and microbiological data collected by an active surveillance program provides useful information about the epidemiology of VRE that can be applied to inform rational infection control strategies.

Outbreaks of Vancomycin-Resistant Enterococci in Hospital Settings: A Systematic Review and Calculation of the Basic Reproductive Number

2015 ◽  
Vol 37 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Laetitia Satilmis ◽  
Philippe Vanhems ◽  
Thomas Bénet
Keyword(s):  
Descriptive Analysis ◽  
Reproductive Rate ◽  
Control Measures ◽  
Basic Reproductive Number ◽  
Reproductive Number ◽  
Surveillance Program ◽  
Vancomycin Resistant Enterococci ◽  
The Mean ◽  
Vancomycin Resistant ◽  
Index Cases

BACKGROUNDVancomycin-resistant enterococci (VRE) have spread worldwide.OBJECTIVETo systematically review VRE outbreaks and estimate the pooled basic reproductive rate (R0) of VRE.METHODSEligible studies criteria were (1) published within 10 years, (2) report outbreak details, (3) involve 1 center, (4) estimate epidemic duration, and (5) concern adults. Descriptive analysis included number of index cases, secondary cases, and screened patients; infection control measures; and definition of contact patients. R0 was estimated by the equation R0=(ln2) D/td+1, with D as the generation time and td as the doubling time.RESULTSThirteen VRE outbreaks were retained from 180 articles and, among them, 10 were kept for R0 calculation. The mean (range) number of index cases was 2.3 (1–8) and the mean (range) number of secondary cases was 15 (3–56). The mean (range) number of screened patients was 174 (32–509), with pooled VRE prevalence of 5.4% (95% CI, 4.5%–6.3%). Contact precautions were reported in 12 studies (92%), wards were closed in 7 (54%), with cohorting in 6 (46%). Two major screening policies were implemented: (1) a surveillance program in the unit or hospital (7 studies [54%]) and (2) screening of selected contact patients (6 studies [46%]). The pooled R0 of VRE was 1.32 (interquartile range, 1.03–1.46).CONCLUSIONWe discerned considerable heterogeneity in screening policies during VRE outbreaks. Pooled R0 was higher than 1, confirming the epidemic nature of VRE.Infect. Control Hosp. Epidemiol. 2016;37(3):289–394

Reporting of Vancomycin-Resistant Enterococci in Connecticut: Implementation and Validation of a State-Based Surveillance System

1999 ◽  
Vol 20 (10) ◽  
pp. 671-675 ◽  
Author(s):  
Zygmunt F. Dembek ◽  
Scott E. Kellerman ◽  
Lisa Ganley ◽  
Constance M. Capacchione ◽  
Fred C. Tenover ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Proficiency Testing ◽  
Clinical Laboratory ◽  
Surveillance Systems ◽  
Passive Surveillance ◽  
Emerging Pathogens ◽  
Clinical Laboratories ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

AbstractObjective:To assess state-based surveillance for isolation from a sterile site of vancomycin-resistant enterococci (VRE) in Connecticut.Design:Clinical laboratory reporting (passive surveillance) of VRE isolates to the Connecticut Department of Public Health (CDPH) was followed by state-initiated validation, laboratory proficiency testing, and review of hospital demographic characteristics.Settings:All 45 clinical laboratories and all 37 (36 for 1995 and 1996) acute-care hospitals in Connecticut were included in the study.Main Outcome Measures:The outcome measures included determination of the statewide incidence of VRE and the accuracy of passive reporting, determination of clinical laboratory proficiency in detecting VRE, and analysis of hospital characteristics that might be associated with an increased incidence of VRE.Results:During 1994 through 1996, 29 (78%) of 37 hospital-affiliated clinical laboratories and 1 (11%) of 9 commercial or other laboratories in Connecticut reported to the CDPH the isolation of VRE from sterile sites; 158 isolates were reported for these 3 years. Based on verification, we discovered that these laboratories actually detected 58 VRE isolates in 1994, 104 in 1995, and 104 in 1996 (total, 266). The age-standardized incidence rate of VRE was 14.1 cases per million population in 1994 and 26.8 cases per million population for both 1995 and 1996. Laboratory proficiency testing revealed that high-level vancomycin resistance was identified accurately and that low- and moderate-level resistance was not detected. The incidence of VRE isolates was three times greater in hospitals with over 300 beds compared with categories of hospitals with fewer beds. Increases in the number of VRE isolates were at least twice as likely in hospitals located in areas with a higher population density, or with a residency program or trauma center in the hospital.Conclusions:Passive reporting of VRE isolates from sterile sites markedly underestimated the actual number of isolates, as determined in a statewide reporting system. Statewide passive surveillance systems for routine or emerging pathogens must be validated and laboratory proficiency ensured if results are to be accurate and substantial underreporting is to be corrected.

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