A Hospital Epidemic of Vancomycin-Resistant Enterococcus Risk Factors and Control

2001 ◽  
Vol 22 (03) ◽  
pp. 140-147 ◽  
Author(s):  
Karin E. Byers ◽  
Anne M. Anglim ◽  
Cynthia J. Anneski ◽  
Teresa P. Germanson ◽  
Howard S. Gold ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Gel Electrophoresis ◽  
Conditional Logistic Regression ◽  
Significant Risk ◽  
Pulsed Field Gel Electrophoresis ◽  
Stepwise Logistic Regression ◽  
Multivariate Models ◽  
Pulsed Field ◽  
Vancomycin Resistant

AbstbactObjective:To determine risk factors for vancomycin-resistantEnterococcus(VRE) colonization during a hospital outbreak and to evaluate Centers for Disease Control and Prevention (CDC)-recommended control measures.Design:Epidemiological study involving prospective identification of colonization and a case-control study.Setting:A university hospital.Participants:Patients on eight wards involved in outbreak from late 1994 through early 1995.Methods:Cases were matched by ward and culture date with up to two controls. Risk factors were evaluated with four multivariate models using conditional logistic regression. The first evaluated proximity to other VRE patients and isolation status. The second evaluated proximity to unisolated VRE cases and three variables independently predictive after adjustment for proximity. The third evaluated seven significant univariate predictors in addition to proximity to unisolated VRE in backward, stepwise logistic regression. The fourth assessed proximity to VRE with all other variables collected, clustered in a principal components analysis. Pulsed-field gel electrophoresis was performed to assess clonality of two outbreak strains.Results:The incidence of transmission declined significantly after CDC guidelines were implemented. Proximity to unisolated VRE cases during the prior week was a significant predictor of acquisition in each of four multivariate models. Other significant risk factors in multivariate models included a history of major trauma and treatment with metronidazole. Pulsed-field gel electrophoresis confirmed the clonality of two outbreak strains.Conclusions:VRE was transmitted between patients during a hospital epidemic, with proximity to previously unisolated VRE patients being an important risk factor. Weekly surveillance cultures and contact isolation of colonized patients significantly reduced spread.

scholarly journals Association of Hypertriglycerideamia with Ischaemic Stroke

2016 ◽  
Vol 32 (1) ◽  
pp. 34-38
Author(s):  
Biplob Kumar Das ◽  
Kanak Jyoti Mondal
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ischaemic Stroke ◽  
Significant Risk ◽  
Serum Triglyceride ◽  
Control Group ◽  
Case Group ◽  
Stepwise Logistic Regression ◽  
Serum Triglyceride Level ◽  
Analysis Model

Stroke is one of the foremost causes of morbidity, mortality and is a socioeconomic challenge. This is particularly true for developing countries like Bangladesh, where health support system including the rehabilitation system is not within the reach of common people. Hypertriglycerademia has an effective influence in the pathogenesis of Ischaemic Stroke (IS). So, the focus of this study was to evaluate and assess the association of serum triglyceride level in patients of IS. This case control study was carried out in the Department of Neurology in collaboration with Department of Biochemistry, BSMMU, Dhaka from July 2011 to June 2013. In this study, 60 diagnosed cases of ischaemic stroke patients and 60 age and sex matched healthy controls were enrolled. Risk factors of Ischemic Stroke (IS) patients were assessed ( adjusted Odds Ratio) in comparison with healthy adults. In this study, being married [OR. 1.95, 95% CI (0.40-9.42), p=0.409] , smoker [OR.1.65, 95% CI (0.57 - 4.82),p= 0.357], DM [OR. 1.48, 95% CI (0.36-6.06), p=0.582 ], IHD [OR. 1.51, 95% CI (0.29 – 7.89), p=0.624] , HTN [OR. 3.66, 95% CI (1.11–12.12), p=0.033] , overweight [OR.2.31, 95% CI (0.77 – 6.91), 0.135] and obesity [OR. 16.19, 95% CI (1.31–200.6), p=0.030] , increased level of serum TC [OR.8.24, 95% CI (2.07 – 32.83), p=0.003], TG [OR. 9.40, 95% CI (1.17 -75.86), p=0.035], LDL [OR. 0.45, 95% CI (0.10–2.05), p=0.308],and decreased level of HDL [OR. 3.37, 95% CI (1.03 - 12.25), p=0.045] were found as risk factors in developing IS. Independent t-test was done to find out the statistically significant differences of continuous variables like serum lipid profile between case and control group. The mean (SD) value of TG which is focus of this study, was found 237.67 (61.74) in case group, and 169.97 (26.95) in control group which was highly statistically significant (p < 0.0001). All of the significant variables were entered into stepwise logistic regression analysis model. From the logistic regression model, it can be finally concluded that hypertension, obesity, increased level of TC, increased level of TG and decreased level of HDL were statistically significant risk factors for development of IS. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 34-38

scholarly journals Vancomycin-Resistant Enterococcus faecium: Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

2005 ◽  
Vol 49 (12) ◽  
pp. 5046-5050 ◽  
Author(s):  
Issam I. Raad ◽  
Hend A. Hanna ◽  
Maha Boktour ◽  
Gassan Chaiban ◽  
Ray Y. Hachem ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Gel Electrophoresis ◽  
Antibiotic Susceptibility ◽  
Pulsed Field Gel Electrophoresis ◽  
Molecular Characteristics ◽  
Vancomycin Resistant Enterococcus ◽  
Catheter Colonization ◽  
Pulsed Field ◽  
Vancomycin Resistant ◽  
Gastrointestinal Colonization

ABSTRACT To evaluate the molecular characteristics and antibiotic susceptibility in biofilm of vancomycin-resistant Enterococcus faecium (VREF) organisms that had caused catheter-related VREF bacteremia (VREF-CRB), we compared 22 isolates causing bacteremia obtained from patients with VREF-CRB with 30 isolates from control patients with gastrointestinal colonization by VREF. Using pulsed-field gel electrophoresis, we identified 17 unique strains among the 22 VREF-CRB isolates and 23 strains among the gastrointestinal isolates. The esp gene was detected in 53% (9 of 17) of the VREF-CRB and 61% (14 of 23) of the control strains (P = 0.6). VREF-CRB produced heavier biofilm colonization of silicone disks than did control organisms (P < 0.001). Daptomycin, minocycline, and quinupristin-dalfopristin were each independently more active than linezolid in reducing biofilm colonization by VREF-CRB (P < 0.01), with daptomycin being the most active, followed by minocycline. In conclusion, the esp gene in VREF is not associated with heavy biofilm colonization or catheter-related bacteremia. In biofilm, daptomycin and minocycline were the most active antibiotics against VREF, and linezolid was the least active.

scholarly journals Molecular Characterization of Glycopeptide-Resistant Enterococcus faecium Isolates from Portuguese Hospitals

2005 ◽  
Vol 49 (7) ◽  
pp. 3073-3079 ◽  
Author(s):  
Carla Novais ◽  
João C. Sousa ◽  
Teresa M. Coque ◽  
Luísa V. Peixe
Keyword(s):  
Molecular Characterization ◽  
Enterococcus Faecium ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Vancomycin Resistant ◽  
Geographical Locations

ABSTRACT Fifty-one pulsed-field gel electrophoresis types and 17 Tn1546 variants were identified among 101 Enterococcus faecium isolates recovered in three distant Portuguese hospitals. Intra- and interhospital dissemination of specific strains and Tn1546 types was detected, which might largely contribute to the endemicity of vancomycin-resistant E. faecium in Portuguese hospitals, as happened previously in other geographical locations.

scholarly journals Local Genetic Patterns within a Vancomycin-Resistant Enterococcus faecalis Clone Isolated in Three Hospitals in Portugal

2004 ◽  
Vol 48 (9) ◽  
pp. 3613-3617 ◽  
Author(s):  
Carla Novais ◽  
Teresa M. Coque ◽  
João Carlos Sousa ◽  
Fernando Baquero ◽  
Luisa Peixe
Keyword(s):  
Enterococcus Faecalis ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Vancomycin Resistant Enterococcus ◽  
Pulsed Field ◽  
Genetic Patterns ◽  
Single Clone ◽  
Vancomycin Resistant

ABSTRACT Eight pulsed-field gel electrophoresis subtypes and six Tn1546 variants were identified among Enterococcus faecalis isolates of a single clone recovered in three geographically separate Portuguese hospitals. Some clonal subtypes were found in particular hospitals, and Tn1546 variants were either widespread or confined to some of them. We also report on the first Tn1546 transposon containing an ISEf1 insertion.

scholarly journals Genetic Analysis of Multiple Vancomycin-ResistantEnterococcus Isolates Obtained Serially from Two Long-Term-Care Patients

1998 ◽  
Vol 36 (7) ◽  
pp. 2105-2108 ◽  
Author(s):  
Dianna J. Schoonmaker ◽  
Lawrence H. Bopp ◽  
Aldona L. Baltch ◽  
Raymond P. Smith ◽  
Mary Ellen Rafferty ◽  
...  
Keyword(s):  
High Risk ◽  
Genetic Analysis ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Risk Of Infection ◽  
Term Care ◽  
Pulsed Field ◽  
Vancomycin Resistant

Fifty-eight vancomycin-resistant enterococcal isolates were obtained from two patients over 9 weeks. Numerous pulsed-field gel electrophoresis fingerprinting types were isolated from each patient. By PCR, all isolates were vanA +. However, many isolates from patient B were found to lack vanA by hybridization. Our results demonstrate the importance of examining multiple isolates, especially from patients who are at high risk of infection.

Identification of Enterococcus faecalis in Different Clonal Lineages with the Pulsed-Field Gel Electrophoresis Method in Imam Khomeini Hospital, Ilam, Iran

2021 ◽  
Vol 14 (11) ◽  
Author(s):  
Farzad Mohamadi ◽  
Jalil Vand Yousefi ◽  
Naser Harzandi ◽  
Sobhan Ghafourian
Keyword(s):  
Enterococcus Faecalis ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Disk Diffusion ◽  
Pulsed Field ◽  
Vana Gene ◽  
Electrophoresis Method ◽  
Typing Methods ◽  
Vancomycin Resistant ◽  
Tract Infections

Background: Due to the importance of identifying the source of infectious agents, different typing methods have been developed, among which the pulsed-field gel electrophoresis (PFGE) method is known as the gold standard for bacteria. Also, Enterococcus faecalis is classified as a nosocomial infection. Objectives: The current study aimed to identify the source of E. faecalis by the PFGE method. Methods: Bacteria were collected from all cases of urinary tract infections. Then, the identification process was performed. All isolates were evaluated for vancomycin resistance, and then PFGE was carried out. Results: The results of disk diffusion showed that 54% of the isolates showed resistance to vancomycin. Also, 4% of the isolates were intermediate, and 42% showed sensitivity to vancomycin. Afterwards, the PCR of the VanA gene was performed to confirm the results of disk diffusion. Thus, 48 out of 54 (88.8%) isolates had the VanA gene, and none of the four intermediate isolates had the VanA gene. Our results demonstrated that 54 isolates were vancomycin-resistant, and 50 different pulsotypes groups were identified. Conclusions: Our findings showed the isolates of E. faecalis were from different clonal lineages.

scholarly journals Relapse and reacquisition of rectal colonization by vancomycin-resistantEnterococcus faeciumafter decolonization

2010 ◽  
Vol 138 (10) ◽  
pp. 1449-1453 ◽  
Author(s):  
W. G. LEE ◽  
I. J. PARK ◽  
H. Y. JIN ◽  
M. H. PARK
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Gel Electrophoresis ◽  
De Novo ◽  
Pulsed Field Gel Electrophoresis ◽  
Hospitalized Patients ◽  
Pulsed Field ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Rectal Colonization

SUMMARYTo better understand the epidemiology of colonization of vancomycin-resistant enterococci (VRE), we performed an 8-year retrospective study of all hospitalized patients with recurrent VRE colonization after they were documented as being clear of VRE and compared the primary colonization isolates and recolonization isolates by pulsed-field gel electrophoresis and Tn1546typing. Review of the medical records of all patients showed that of the 15 patients with recurrent colonization, six continued to be hospitalized on the same floor. Five were discharged home and then readmitted. Four were moved to another floor. Patients who remained on the same floor were recolonized with a strain that was indistinguishable from the original colonizing strain. Patients who were moved or were discharged hadde novoVRE colonization with strains distinct from the original colonizing strain.

scholarly journals Isolation of VanA-Type Vancomycin-Resistant Enterococcus Strains from Domestic Poultry Products with Enrichment by Incubation in Buffered Peptone Water at 42�C

2010 ◽  
Vol 76 (15) ◽  
pp. 5317-5320 ◽  
Author(s):  
Tetsuya Harada ◽  
Masashi Kanki ◽  
Takao Kawai ◽  
Masumi Taguchi ◽  
Tsutomu Asao ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Vancomycin Resistant Enterococcus ◽  
Pulsed Field ◽  
Poultry Products ◽  
Domestic Poultry ◽  
Peptone Water ◽  
Vancomycin Resistant

ABSTRACT Eight VanA-type enterococcal strains were isolated from 8 of 171 domestic poultry products by using enrichment by incubation in buffered peptone water at 35�C and 42�C. The pulsed-field gel electrophoresis patterns of all six VanA-type Enterococcus faecalis isolates were nearly indistinguishable, indicating the presence of a specific clone in Japan.

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