Undetected Vancomycin-Resistant Enterococcus Stool Colonization in a Veterans Affairs Hospital Using a Clostridium difficile–Focused Surveillance Strategy

2002 ◽  
Vol 23 (8) ◽  
pp. 474-477 ◽  
Author(s):  
Amy J. Ray ◽  
Claudia K. Hoyen ◽  
Sarbani M. Das ◽  
Elizabeth C. Eckstein ◽  
Curtis J. Donskey
Keyword(s):  
Clostridium Difficile ◽  
Veterans Affairs ◽  
Point Prevalence ◽  
Vancomycin Resistant Enterococcus ◽  
Surveillance Strategy ◽  
Stool Samples ◽  
Vancomycin Resistant

Abstract We examined the point prevalence of undetected vancomycin-resistant Enterococcus (VRE) stool colonization in an institution that screens stool samples submitted for Clostridium difficile testing. Of 112 patients not known to be colonized, 10 (9%) had rectal VRE colonization. A prospective algorithm was effective for identification of colonized patients.

scholarly journals Clearance of Vancomycin-Resistant Enterococcus Concomitant With Administration of a Microbiota-Based Drug Targeted at Recurrent Clostridium difficile Infection

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Erik R. Dubberke ◽  
Kathleen M. Mullane ◽  
Dale N. Gerding ◽  
Christine H. Lee ◽  
Thomas J. Louie ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Small Sample Size ◽  
Secondary Analysis ◽  
Small Sample ◽  
Vancomycin Resistant Enterococcus ◽  
Recurrent Clostridium Difficile Infection ◽  
Stool Samples ◽  
Vancomycin Resistant

Abstract Background.  Vancomycin-resistant Enterococcus (VRE) is a major healthcare-associated pathogen and a well known complication among transplant and immunocompromised patients. We report on stool VRE clearance in a post hoc analysis of the Phase 2 PUNCH CD study assessing a microbiota-based drug for recurrent Clostridium difficile infection (CDI). Methods.  A total of 34 patients enrolled in the PUNCH CD study received 1 or 2 doses of RBX2660 (microbiota suspension). Patients were requested to voluntarily submit stool samples at baseline and at 7, 30, and 60 days and 6 months after the last administration of RBX2660. Stool samples were tested for VRE using bile esculin azide agar with 6 µg/mL vancomycin and Gram staining. Vancomycin resistance was confirmed by Etest. Results.  VRE status (at least 1 test result) was available for 30 patients. All stool samples for 19 patients (63.3%, mean age 61.7 years, 68% female) tested VRE negative. Eleven patients (36.7%, mean age 75.5 years, 64% female) were VRE positive at the first test (baseline or 7-day follow-up). Of these patients, 72.7%, n = 8 converted to negative as of the last available follow-up (30 or 60 days or 6 months). Of the other 3: 1 died (follow-up data not available); 1 patient remained positive at all follow-ups; 1 patient retested positive at 6 months with negative tests during the interim. Conclusions.  Although based on a small sample size, this secondary analysis demonstrated the possibility of successfully converting a high percentage of VRE-positive patients to negative in a recurrent CDI population with RBX2660.

Reduction in Vancomycin-Resistant Enterococcus and Clostridium difficile Infections following Change to Tympanic Thermometers

1998 ◽  
Vol 19 (5) ◽  
pp. 333-336 ◽  
Author(s):  
Steven Brooks ◽  
Ashraf Khan ◽  
Dorin Stoica ◽  
Jennylyn Griffith ◽  
Les Friedeman ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Resistant

Reduction in Vancomycin-Resistant Enterococcus and Clostridium difficile Infections following Change to Tympanic Thermometers

1998 ◽  
Vol 19 (5) ◽  
pp. 333-336 ◽  
Author(s):  
Steven Brooks ◽  
Ashraf Khan ◽  
Dorin Stoica ◽  
Jennylyn Griffith ◽  
Les Friedeman ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Resistant

Practical methods for effective vancomycin-resistant enterococci (VRE) surveillance: experience in a liver transplant surgical intensive care unit

2018 ◽  
Vol 39 (10) ◽  
pp. 1178-1182 ◽  
Author(s):  
Rebecca Y. Linfield ◽  
Shelley Campeau ◽  
Patil Injean ◽  
Aric Gregson ◽  
Fady Kaldas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Tertiary Care ◽  
Point Prevalence ◽  
Surgical Intensive Care Unit ◽  
Fisher Exact Test ◽  
Surgical Intensive Care ◽  
Stool Samples ◽  
Vancomycin Resistant

AbstractObjectiveWe evaluated the utility of vancomycin-resistant Enterococcus (VRE) surveillance by varying 2 parameters: admission versus weekly surveillance and perirectal swabbing versus stool sampling.DesignProspective, patient-level surveillance program of incident VRE colonization.SettingLiver transplant surgical intensive care unit (SICU) of a tertiary-care referral medical center with a high prevalence of VRE.PatientsAll patients admitted to the SICU from June to August 2015.MethodsWe conducted a point-prevalence estimate followed by admission and weekly surveillance by perirectal swabbing and/or stool sampling. Incident colonization was defined as a negative screen followed by positive surveillance. VRE was detected by culture on Remel Spectra VRE chromogenic agar. Microbiologically-confirmed VRE bloodstream infections (BSIs) were tracked for 2 months. Statistical analyses were calculated using the McNemar test, the Fisher exact test, the t test, and the χ2 test.ResultsIn total, 91 patients underwent VRE surveillance testing. The point prevalence of VRE colonization was 60.9%; VRE prevalence on admission was 30.1%. Weekly surveillance identified an additional 7 of 28 patients (25.0%) with incident colonization. VRE BSIs were more common in VRE-colonized patients than in noncolonized patients (8 of 43 vs 2 of 48; P=.028). In a direct comparison, perirectal swabs were more sensitive than stool samples in detecting VRE (64 of 67 vs 56 of 67; P=.023). Compliance with perirectal swabbing was 89% (201 of 226) compared to 56% (127 of 226) for stool collection (P≤0.001).ConclusionsWe recommend weekly VRE surveillance over admission-only screening in high-burden units such as liver transplant SICUs. Perirectal swabs had greater collection compliance and sensitivity than stool samples, making them the preferred methodology. Further work may have implications for antimicrobial stewardship and infection control.

scholarly journals Screening of Stool Samples for Identification of Vancomycin-Resistant Enterococcus Isolates Should Include the Methyl-α-dGlucopyranoside Test To Differentiate Nonmotile Enterococcus gallinarum from E. faecium

1998 ◽  
Vol 36 (8) ◽  
pp. 2333-2335 ◽  
Author(s):  
Christine Y. Turenne ◽  
Daryl J. Hoban ◽  
James A. Karlowsky ◽  
George G. Zhanel ◽  
Amin M. Kabani
Keyword(s):  
16S Rdna ◽  
Enterococcus Faecium ◽  
Surveillance Study ◽  
Vancomycin Resistant Enterococcus ◽  
Stool Samples ◽  
Vancomycin Resistant ◽  
Enterococcus Gallinarum

The methyl-α-d-glucopyranoside (MDG) test has been shown to be superior to motility testing in differentiatingEnterococcus faecium from E. gallinarum. In the present study, 33 vancomycin-resistant enterococcus (VRE) isolates collected as part of a stool surveillance study were compared by using motility and MDG. Motility testing identified all 33 isolates asE. faecium, whereas MDG identified 11 of the 33 isolates as nonmotile E. gallinarum. The MDG results were confirmed by sequencing the 16S rDNA V6-to-V8 region. We conclude that the MDG test is a necessary component of routine VRE screening.

Sign in / Sign up

Export Citation Format

Share Document