Vancomycin-Resistant Enterococci in Stool Specimens Submitted for Clostridium difficile Cytotoxin Assay

1997 ◽  
Vol 18 (5) ◽  
pp. 342-344 ◽  
Author(s):  
Mary Ellen Rafferty ◽  
Malkanthie I. McCormick ◽  
Lawrence H. Bopp ◽  
Aldona L. Baltch ◽  
Mary George ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Vancomycin Resistant Enterococci ◽  
Stool Specimens ◽  
Vancomycin Resistant

Laboratory-Based Surveillance for Vancomycin-Resistant Enterococci: Utility of Screening Stool Specimens Submitted for Clostridium difficile Toxin Assay

2001 ◽  
Vol 22 (03) ◽  
pp. 160-164 ◽  
Author(s):  
Amy L. Leber ◽  
Janet F. Hindler ◽  
Ellen O. Kato ◽  
David A. Bruckner ◽  
David A. Pegues
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Hospitalized Patients ◽  
University Teaching ◽  
Toxin A ◽  
Vancomycin Resistant Enterococci ◽  
Positive Stool ◽  
Toxin Assay ◽  
Stool Specimens ◽  
Vancomycin Resistant

AbstractObjective:To study vancomycin-resistant enterococci (VRE) gastrointestinal colonization prevalence in high-risk hospitalized patients and to assess the cost and utility of this laboratory-based surveillance.Setting:Large university teaching hospital.Design:Quarterly prevalence culture survey of 50 stool specimens submitted forClostridium difficiletoxin A assay from October 1996 through June 1999 (n=526). Screening culture survey of allC difficile-positive stool specimens from July 1998 through June 1999 (n=140).Patients:Specimens for analysis were collected from patients who were admitted to the hospital and who hadC difficiletoxin A testing ordered. Patient samples were excluded from analysis if they were obtained from patients not hospitalized at UCLA Medical Center, if theC difficiletoxin assay result was indeterminate, or if the patient was known to have previous VRE colonization or infection.Results:During quarterly surveillance, VRE was detected in 19.8%,C difficiletoxin A in 9.5%, and both VRE andC difficiletoxin A in 3.2% of stool specimens submitted forC difficiletoxin assay. Patients whose stool specimens were positive forC difficiletoxin A were significantly more likely than those whose specimens were negative to have VRE detected (odds ratio, 2.3; 95% confidence interval, 1.2-4.5). Based on these findings, in July 1998, we began routine screening of allC difficile-positive stool specimens for VRE. From July 1998 through June 1999, 58 (41.4%) of 140 patients withC difficile-positive specimens had VRE newly detected in the stool. The combined cost of the two laboratory-based surveillance strategies was approximately $62 per VRE-positive patient identified and $5,800 per year.Conclusion:Quarterly surveillance of stool submitted forC difficileassay combined with screening allC difficile-positive stools is a cost-effective and efficient strategy for detecting VRE stool colonization among high-risk hospitalized patients. Such a laboratory-based surveillance should be included as part of a comprehensive program to limit nosocomial VRE transmission.

Vancomycin-Resistant Enterococci in Stool Specimens Submitted for Clostridium difficile Cytotoxin Assay

1997 ◽  
Vol 18 (5) ◽  
pp. 342-344 ◽  
Author(s):  
Mary Ellen Rafferty ◽  
Malkanthie I. McCormick ◽  
Lawrence H. Bopp ◽  
Aldona L. Baltch ◽  
Mary George ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Vancomycin Resistant Enterococci ◽  
Stool Specimens ◽  
Vancomycin Resistant

scholarly journals Differences in Hospital-Associated Multidrug-Resistant Organisms and Clostridium difficile Rates Using 2-Day versus 3-Day Definitions

2014 ◽  
Vol 35 (11) ◽  
pp. 1417-1420 ◽  
Author(s):  
Adrijana Gombosev ◽  
Salah E. Fouad ◽  
Eric Cui ◽  
Chenghua Cao ◽  
Leah Terpstra ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Multidrug Resistant ◽  
Infect Control Hosp ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Multidrug Resistant Organisms ◽  
Vancomycin Resistant

We surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant Acinetobacter acquisition, as well as hospital-associated MRSA bacteremia and Clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. The former resulted in significantly higher median rates, ranging from 6.76% to 45.07% higherInfect Control Hosp Epidemiol 2014;35(11):1417–1420

Contamination of Hospital Curtains With Healthcare-Associated Pathogens

2008 ◽  
Vol 29 (11) ◽  
pp. 1074-1076 ◽  
Author(s):  
Floyd Trillis ◽  
Elizabeth C. Eckstein ◽  
Rachel Budavich ◽  
Michael J. Pultz ◽  
Curtis J. Donskey
Keyword(s):  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Methicillin Resistant ◽  
Potential Source ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Healthcare Associated

In a culture survey, we found that 42% of hospital privacy curtains were contaminated with vancomycin-resistant enterococci, 22% with methicillin-resistant Staphylococcus aureus, and 4% with Clostridium difficile. Hand imprint cultures demonstrated that these pathogens were easily acquired on hands. Hospital curtains are a potential source for dissemination of healthcare-associated pathogens.

scholarly journals A Phenotypically Silent vanB2 Operon Carried on a Tn1549-Like Element in Clostridium difficile

mSphere ◽  
2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Daniel R. Knight ◽  
Grace O. Androga ◽  
Susan A. Ballard ◽  
Benjamin P. Howden ◽  
Thomas V. Riley
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Resistance Genes ◽  
Vancomycin Resistance ◽  
Content Type ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Emergence Of Resistance ◽  
First Time

ABSTRACT In an era when the development of new antimicrobial drugs is slow, vancomycin remains the preferred antimicrobial therapy for Clostridium difficile infection (CDI), the most important health care-related infection in the world today. The emergence of resistance to vancomycin would have significant consequences in relation to treating patients with CDI. In this paper, we describe for the first time a complete set of vancomycin resistance genes in C. difficile. The genes were very similar to genes found in vancomycin-resistant enterococci (VRE) that were associated with the emergence and global dissemination of this organism. Fortunately, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly because of a small difference in one gene. However, this observation signals that we may be very close to seeing a fully vancomycin-resistant strain of C. difficile. In the last decade, Clostridium difficile infection (CDI) has reached an epidemic state with increasing incidence and severity in both health care and community settings. Vancomycin is an important first-line therapy for CDI, and the emergence of resistance would have significant clinical consequences. In this study, we describe for the first time a vanB2 vancomycin resistance operon in C. difficile, isolated from an Australian veal calf at slaughter. The operon was carried on an ~42-kb element showing significant homology and synteny to Tn1549, a conjugative transposon linked with the emergence and global dissemination of vancomycin-resistant enterococci (VRE). Notably, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly as a result of an aberrant vanRB gene. As observed for other anaerobic species of the animal gut microbiota, C. difficile may be a reservoir of clinically important vancomycin resistance genes. IMPORTANCE In an era when the development of new antimicrobial drugs is slow, vancomycin remains the preferred antimicrobial therapy for Clostridium difficile infection (CDI), the most important health care-related infection in the world today. The emergence of resistance to vancomycin would have significant consequences in relation to treating patients with CDI. In this paper, we describe for the first time a complete set of vancomycin resistance genes in C. difficile. The genes were very similar to genes found in vancomycin-resistant enterococci (VRE) that were associated with the emergence and global dissemination of this organism. Fortunately, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly because of a small difference in one gene. However, this observation signals that we may be very close to seeing a fully vancomycin-resistant strain of C. difficile.

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