scholarly journals Reinstatement of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci (VRE) Resulted in Decreased Incidence of Hospital-Associated VRE

2017 ◽  
Vol 38 (5) ◽  
pp. 619-621 ◽  
Author(s):  
Satish Munigala ◽  
Kathleen M. McMullen ◽  
Anthony J. Russo ◽  
S. Reza Jafarzadeh ◽  
Joan Hoppe-Bauer ◽  
...  
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Reflex Testing ◽  
Stool Samples ◽  
Vancomycin Resistant

scholarly journals Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

2013 ◽  
Vol 34 (8) ◽  
pp. 838-840 ◽  
Author(s):  
Mandy Bodily ◽  
Kathleen M. McMullen ◽  
Anthony J. Russo ◽  
Nupur D. Kittur ◽  
Joan Hoppe-Bauer ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Hospital Costs ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Vancomycin Resistant Enterococci ◽  
Number Of Patients ◽  
Reflex Testing ◽  
Stool Samples ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Discontinuation of reflex testing of stool submitted forClostridium difficiletesting for vancomycin-resistant enterococci (VRE) led to an increase in the number of patients with healthcare-associated VRE bacteremia and bacteriuria (0.21 vs 0.36 cases per 1,000 patient-days;P< .01). Cost-benefit analysis showed reflex screening and isolation of VRE reduced hospital costs.

scholarly journals Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

2012 ◽  
Vol 40 (5) ◽  
pp. e198
Author(s):  
Kathleen McMullen ◽  
Mandy Bodily ◽  
Kathleen McMullen ◽  
Anthony Russo ◽  
Joan Hoppe-Bauer ◽  
...  
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Reflex Testing ◽  
Stool Samples ◽  
Vancomycin Resistant

Evaluation of Need for Vancomycin-Resistant Enterococci (VRE) Reflex Testing

2018 ◽  
Vol 46 (6) ◽  
pp. S16-S17
Author(s):  
Tasha M. Turner ◽  
Jeanne Yegge ◽  
Katherine Yohnke ◽  
Janice Setzer ◽  
Ashleigh J. Goris
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Reflex Testing ◽  
Vancomycin Resistant

scholarly journals Evaluation of chromogenic media for the isolation of vancomycin-resistant enterococci from stool samples

2009 ◽  
Vol 48 (2) ◽  
pp. 230-233 ◽  
Author(s):  
K. Asir ◽  
K. Wilkinson ◽  
J.D. Perry ◽  
R.H. Reed ◽  
F.K. Gould
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Stool Samples ◽  
Vancomycin Resistant

scholarly journals Evidence for Biliary Excretion of Vancomycin into Stool during Intravenous Therapy: Potential Implications for Rectal Colonization with Vancomycin-Resistant Enterococci

2004 ◽  
Vol 48 (11) ◽  
pp. 4427-4429 ◽  
Author(s):  
Brian P. Currie ◽  
Luciano Lemos-Filho
Keyword(s):  
Biliary Excretion ◽  
Intravenous Therapy ◽  
Vancomycin Therapy ◽  
Competitive Immunoassay ◽  
Vancomycin Resistant Enterococci ◽  
Stool Samples ◽  
Vancomycin Resistant ◽  
Almost All ◽  
Rectal Colonization ◽  
Bile Samples

ABSTRACT Sixty-three stool samples and five bile samples were prospectively collected from 33 patients receiving intravenous vancomycin therapy and were quantitatively analyzed for vancomycin by a competitive immunoassay. Vancomycin was excreted via bile into the stools of almost all patients at concentrations of 3.3 to 94.8 μg/ml after ≥5 days of a therapy of 1 g every 12 h.

scholarly journals Multidrug-Resistant Organism Carriage in Wisconsin Children

2020 ◽  
Vol 41 (S1) ◽  
pp. s324-s325
Author(s):  
Ashley Kates ◽  
Nathan Putman-Buehler ◽  
Lauren Watson ◽  
Tamara LeCaire ◽  
Kristen Malecki ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Kindergarten Children ◽  
Resistant Organism ◽  
Small Pilot Study ◽  
Cross Sectional ◽  
Vancomycin Resistant Enterococci ◽  
Increased Risk ◽  
Stool Samples ◽  
Vancomycin Resistant

Background: Children attending daycare are at increased risk of carrying multidrug-resistant organisms (MDROs) compared to children not attending daycare. Carriage of MDROs greatly increases the risk of infection, not only in the child but also for others living in the household. Understanding the epidemiology of MDRO carriage in children is essential to devising effective containment strategies. Here, we present the findings from a cross-sectional study assessing MDRO carriage in daycare-attending and nonattending children in Wisconsin. Methods: We applied the following enrollment criteria: Children aged between 6 months and <6 years and not enrolled in kindergarten; children who did not have an MDRO infection in the previous 6 months and did not receive any antimicrobials in the previous month; and children who did not have a gluten allergy, asthma, eczema, allergic rhinitis, cystic fibrosis, or an immunodeficiency. Children were enrolled by a parent or guardian who filled out a questionnaire on MDRO risk factor history and diet. Samples were collected from the nares, axilla or groin (pooled swab), and stool. Nasal samples were cultured for H. influenzae, S. pneumoniae, M. catarrhalis, and methicillin-resistant S. aureus (MRSA). Skin samples were cultured for MRSA, and stool samples were cultured for MRSA, C. difficile, vancomycin-resistant enterococci (VRE), and extended-spectrum β-lactamase–producing Gram-negative bacilli (ie, ESBL GNR). Results: In total, 44 children were enrolled in this study. The average age was 2.6 years and 50% were girls. Furthermore, 30 (68.2%) were identified by their parents as white, 9 (20.5%) as black, and 5 (11.3%) as other or multiracial. Incidentally, 23 children (52.3%) were enrolled in daycare. Overall, 18 children were positive for at least 1 organism, 9 of which had daycare exposure, and 5 children (1 in daycare) were positive for >1 organism (11.4%). From stool samples, 6 children (13.6%, 2 in daycare) were C. difficile carriers, 3 were VRE carriers (6.8%, 1 in daycare), 8 carried an ESBL GNR (18.2%, 4 in daycare), and 3 carried MRSA (6.8%, 1 in daycare). One child was positive for H. influenzae (2.3%, not in daycare) and 2 were positive for S. pneumoniae (4.6%, 1 in daycare) from nares swabs. One child was positive for MRSA (2.3%, not in daycare) from a skin swab. We detected no significant differences between children with and without daycare exposure for any organism. Conclusions: Children in this population had higher than expected rates of ESBL GNRs and MRSA for a community population. Daycare exposure was not correlated with increased carriage in this small pilot study, though larger longitudinal studies are needed.Funding: NoneDisclosures: None

scholarly journals Surveillance for Vancomycin-Resistant Enterococci: Type, Rates, Costs, and Implications

2006 ◽  
Vol 27 (10) ◽  
pp. 1068-1075 ◽  
Author(s):  
Brooke N. Shadel ◽  
Laura A. Puzniak ◽  
Kathleen N. Gillespie ◽  
Steven J. Lawrence ◽  
Marin Kollef ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Prospective Observational Study ◽  
Stool Specimen ◽  
Rectal Swab ◽  
Cost Savings ◽  
Cost Effective ◽  
Vancomycin Resistant Enterococci ◽  
Stool Samples ◽  
Surveillance Method ◽  
Vancomycin Resistant

Objective.To evaluate 2 active surveillance strategies for detection of enteric vancomycin-resistant enterococci (VRE) in an intensive care unit (ICU).Design.Thirty-month prospective observational study.Setting.ICU at a university-affiliated referral center.Patients.All patients with an ICU stay of 24 hours or more were eligible for the study.Intervention.Clinical active surveillance (CAS), involving culture of a rectal swab specimen for detection of VRE, was performed on admission, weekly while the patient was in the ICU, and at discharge. Laboratory-based active surveillance (LAS), involving culture of a stool specimen for detection of VRE, was performed on stool samples submitted forClostridium difficiletoxin detection.Results.Enteric colonization with VRE was detected in 309 (17%) of 1,872 patients. The CAS method initially detected 280 (91%) of the 309 patients colonized with VRE, compared with 25 patients (8%) detected by LAS; colonization in 4 patients (1%) was initially detected by analysis of other clinical specimens. Most patients with colonization (76%) would have gone undetected by LAS alone, whereas use of the CAS method exclusively would have missed only 3 patients (1%) who were colonized. CAS cost $1,913 per month, or $57,395 for the 30-month study period. Cost savings of CAS from preventing cases of VRE colonization and bacteremia were estimated to range from $56,258 to $303,334 per month.Conclusions.A patient-based CAS strategy for detection of enteric colonization with VRE was superior to LAS. In this high-risk setting, CAS appeared to be the most efficient and cost-effective surveillance method. The modest costs of CAS were offset by the averted costs associated with the prevention of VRE colonization and bacteremia.

scholarly journals Both Oral Metronidazole and Oral Vancomycin Promote Persistent Overgrowth of Vancomycin-Resistant Enterococci during Treatment of Clostridium difficile-Associated Disease

2008 ◽  
Vol 52 (7) ◽  
pp. 2403-2406 ◽  
Author(s):  
Wafa N. Al-Nassir ◽  
Ajay K. Sethi ◽  
Yuejin Li ◽  
Michael J. Pultz ◽  
Michelle M. Riggs ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Prospective Observational Study ◽  
Oral Vancomycin ◽  
The Past ◽  
Vancomycin Resistant Enterococci ◽  
Stool Samples ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
Vancomycin Treatment ◽  
Oral Metronidazole

ABSTRACT For treatment of mild to moderate Clostridium difficile-associated disease (CDAD), oral metronidazole has been recommended as the preferred agent, in part due to concern that vancomycin may be more likely to promote colonization by vancomycin-resistant enterococci (VRE). We performed a prospective observational study to examine the effects of oral metronidazole or vancomycin treatment of CDAD on acquisition and concentration of VRE stool colonization. Before, during, and after 90 courses of CDAD therapy, stool samples were cultured for VRE, and the concentrations were quantified. Eighty-seven subjects (97%) had received antibiotics within the past month. For 56 treatment courses in which preexisting VRE colonization was present, metronidazole (n = 37 courses) and vancomycin (n = 19 courses), each promoted persistent VRE overgrowth during therapy, and the concentration decreased significantly in both groups by ∼2 weeks after completion of treatment (P <0.049). For 34 treatment courses in which baseline cultures were negative for VRE, new detection of VRE stool colonization occurred during 3 (14%) of the 22 courses of metronidazole and 1 (8%) of the 12 courses of vancomycin (P = 1.0). These results demonstrate that both oral metronidazole and oral vancomycin promote the overgrowth of VRE during treatment of CDAD. New CDAD treatments are needed that are less likely to disrupt the intestinal microflora and promote overgrowth of healthcare-associated pathogens.

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