scholarly journals Evaluation of Compliance in Control and Prevention Study of Vancomycin Resistant Enterococcus Outbreak

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Vuslat Kecik Bosnak ◽  
Mustafa Namiduru ◽  
Ilkay Karaoglan ◽  
Ayse Ozlem Mete
Keyword(s):  
Rectal Swab ◽  
Close Contact ◽  
Prevention Study ◽  
Patient Room ◽  
Contact Isolation ◽  
Vancomycin Resistant Enterococci ◽  
Isolation Methods ◽  
Control And Prevention ◽  
Vancomycin Resistant ◽  
The Impact

Objective. Vancomycin resistant enterococci (VRE) colonization and the spread decrease with compliance and isolation guidelines. For the isolation methods to succeed, compliance with the isolation guidelines needs to be overseen. In this study, VRE outbreak among the Pediatric Ward patients, the preventative efforts to control this outbreak, and the impact of scoring tables used in controlling this outbreak on the success are explained.Design. Rectal swab cultures were taken from patients who were admitted to the Ward between October and December 2010 due to diagnoses of VRE and urinary tract infection.Results. VRE were isolated in the rectal swab samples of 34 patients. VRE infection findings were clinically detected in two of the cases with VRE isolation. Two isolations of VRE were detected on cultures from patient room door handle surface and the telephone in the room for common use. Close contact isolation was achieved and barrier precautions were taken for all cases, as soon as the detections were made. A scoring system was developed to evaluate the feasibility of and the compliance with the precautions to be taken.Conclusions. With the method presented in this study, the outbreak at our hospital was under control within two months.

Control of Vancomycin-Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting

1999 ◽  
Vol 20 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Elise M. Jochimsen ◽  
Laurie Fish ◽  
Kelly Manning ◽  
Sally Young ◽  
Daniel A. Singer ◽  
...  
Keyword(s):  
Community Hospital ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Contact Isolation ◽  
Point Prevalence Survey ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
The Impact

AbstractObjective:To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.Design:To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point-prevalence survey was repeated 2 months after the cohort ward was established.Results:Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients,P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients,P=.002); and observed staff-patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions,P<.0001).Conclusions:Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.

Fourier-Transform Infrared (FTIR) Spectrophotometry: An Ecofriendly Method for the Analysis of Injectable Daptomycin

2017 ◽  
Vol 100 (5) ◽  
pp. 1569-1576 ◽  
Author(s):  
Eliane Gandolpho Tótoli ◽  
Hérida Regina Nunes Salgado
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Sustainable Consumption ◽  
Toxic Waste ◽  
Vancomycin Resistant Enterococci ◽  
Ir Spectrophotometry ◽  
Vancomycin Resistant ◽  
Ftir Spectrophotometry ◽  
The Impact

Abstract Daptomycin (DPT) is an important antimicrobial agent used in clinical practice because it is very active against several types of medicinally challengingGram-positive bacteria, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci. In addition to concerns about the quality of the analytical methods used in the QC of drugs, there is also concern about the impact of these methods on the environment. The trend toward sustainable consumption is increasingly evident and has forced the pharmaceutical industry to reduce the generation of toxic waste. Inthis context, IR spectrophotometry stands out because it does not use organic solvents and, although it is formally accepted for the identification of individual compounds, also allows the quantification of substances. Therefore, the aim of this work was to develop and validate a green analytical method for theanalysis of DPT in a lyophilized powder for injection by FTIR spectrophotometry. The method involved absorbance measurements in the spectral region of 1700–1600 cm−1. The method was properly validated and found to be linear, precise, accurate, selective, and robust for the concentrationrange between 0.2 and 0.6 mg/150 mg. The validated method was able to quantify DPT powder for injection and can be used as an environmentally friendly alternative for routine analysis in QC.

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 Risk Factors for New Detection of Vancomycin-Resistant Enterococci in Acute-Care Hospitals That Employ Strict Infection Control Procedures

2003 ◽  
Vol 47 (8) ◽  
pp. 2492-2498 ◽  
Author(s):  
Alexander A. Padiglione ◽  
Rory Wolfe ◽  
Elizabeth A. Grabsch ◽  
Di Olden ◽  
Stephen Pearson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Broad Spectrum ◽  
Rectal Swab ◽  
High Risk Patients ◽  
Vancomycin Resistant Enterococci ◽  
Risk Patients ◽  
Vancomycin Resistant

ABSTRACT Accurate assessment of the risk factors for colonization with vancomycin-resistant enterococci (VRE) among high-risk patients is often confounded by nosocomial VRE transmission. We undertook a 15-month prospective cohort study of adults admitted to high-risk units (hematology, renal, transplant, and intensive care) in three teaching hospitals that used identical strict infection control and isolation procedures for VRE to minimize nosocomial spread. Rectal swab specimens for culture were regularly obtained, and the results were compared with patient demographic factors and antibiotic exposure data. Compliance with screening was defined as “optimal” (100% compliance) or “acceptable” (minor protocol violations were allowed, but a negative rectal swab specimen culture was required within 1 week of becoming colonized with VRE). Colonization with VRE was detected in 1.56% (66 of 4,215) of admissions (0.45% at admission and 0.83% after admission; the acquisition time was uncertain for 0.28%), representing 1.91% of patients. No patients developed infection with VRE. The subsequent rate of new acquisition of VRE was 1.4/1,000 patient days. Renal units had the highest rate (3.23/1,000 patient days; 95% confidence interval [CI], 1.54 to 6.77/1,000 patient days). vanB Enterococcus faecium was the most common species (71%), but other species included vanB Enterococcus faecalis (21%), vanA E. faecium (6%), and vanA E. faecalis (2%). The majority of isolates were nonclonal by pulsed-field gel electrophoresis analysis. Multivariate analysis of risk factors in patients with an acceptable screening suggested that being managed by a renal unit (hazard ratio [HR] compared to the results for patients managed in an intensive care unit, 4.6; 95% CI, 1.2 to 17.0 [P = 0.02]) and recent administration of either ticarcillin-clavulanic acid (HR, 3.6; 95% CI, 1.1 to 11.6 [P = 0.03]) or carbapenems (HR, 2.8; 95% CI, 1.0, 8.0 [P = 0.05]), but not vancomycin or broad-spectrum cephalosporins, were associated with acquisition of VRE. The relatively low rates of colonization with VRE, the polyclonal nature of most isolates, and the possible association with the use of broad-spectrum antibiotics are consistent with either the endogenous emergence of VRE or the amplification of previously undetectable colonization with VRE among high-risk patients managed under conditions in which the risk of nosocomial acquisition was minimized.

scholarly journals Importance of daptomycin dosage on the clinical outcomes in early post-liver transplant recipients with vancomycin-resistant enterococci infection

2021 ◽  
Author(s):  
Ing-Kit Lee ◽  
Yi-Ping Sng ◽  
Wei-Feng Li ◽  
Chao-Long Chen ◽  
Chih-Chi Wang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Level Of Evidence ◽  
Donor Liver Transplantation ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Liver Transplant Recipients ◽  
The Impact

Abstract Background: The prevalence of vancomycin-resistant enterococci (VRE) is increasing among liver transplant recipients. This study aimed to explore the clinical features of liver transplant recipients with VRE infection/colonization and to determine the impact of daptomycin dosage on the outcomes. Methods: We retrospectively enrolled pre-transplant and post-transplant patients with VRE colonization/infection from 2016 to 2019. Results: Altogether, 428 patients underwent liver transplantation. Among these, 22 (5.1%) patients developed VRE colonization/infection. All VRE isolates were Enterococcus faecium. Two (9%) patients acquired VRE in the pre-transplant period, 16 (3 colonizations and 13 infections) (72.7%) in the early post-liver transplant period (≤60-day after transplantation), and 4 (2 colonization and 2 infections) (18.1%) in the late post-liver transplant period (>6-month after transplantation). Among 13 patients with early post-liver transplant VRE infection, 12 (92.3%) underwent living-donor liver transplantation and 1 underwent deceased donor liver transplantation. Among these 13 patients, the median time from transplant to emergence of VRE infection was 12 days. The median interval from VRE infection to death was 27 days and the 30-day mortality was 67%. Of these 13 patients, eleven patients (8 survived; 3 died) received daptomycin therapy for VRE. Among them, 4 (36.3%) received daptomycin doses <8 mg/kg. Non-survivors (n=3) received significantly lower daptomycin dose than survivors (n=8) (P=0.040). Daptomycin doses <8mg/kg were more frequently associated with non-survivors (n=3) than with survivors (n=8) (P=0.024). Conclusions: In summary, the suboptimal dosage of daptomycin may have contributed to a higher rate of in-hospital mortality. Doses ≥8 mg/kg may be needed to adequately treat VRE infection in early post-liver transplant recipients.Level of evidence: Level III

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