179. The Determination of Vancomycin-Resistant Enterococci Contamination of Environmental Surfaces Within a University Medical Center

1999 ◽  
Author(s):  
C. Olmstead
Keyword(s):  
Medical Center ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant

scholarly journals Vancomycin-Resistant Enterococci and Extended-Spectrum β-Lactamase-Producing Bacterial Colonization of the Cervix after Emergency Cerclage: Is It Safe?

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 933
Author(s):  
Won-Kyu Jang ◽  
Jin-Gon Bae
Keyword(s):  
Early Onset ◽  
Neonatal Death ◽  
Medical Center ◽  
Bacterial Colonization ◽  
Control Group ◽  
Vancomycin Resistant Enterococci ◽  
Extended Spectrum ◽  
Early Onset Sepsis ◽  
Cervical Surgery ◽  
Vancomycin Resistant

Antimicrobial resistance is currently becoming a global threat to human health. We performed a retrospective study on patients who underwent emergency cerclage between January 2016 and December 2018 at the Dongsan Medical Center. Cervical culture was first performed before surgery to confirm that there was no infection and was repeated on days 1, 4, and 7 after surgery. A total of 85 pregnant women underwent emergency cerclage. Among them, six patients had vancomycin-resistant enterococci (VRE) colonization in the cervix after cerclage, and 23 patients developed extended-spectrum β-lactamase (ESBL)-producing bacterial colonization in the cervix. The average gestational age at delivery was lower in the VRE group. Neonatal death was also significantly higher in the VRE group. The rate of occurrence of early-onset sepsis was also higher in the VRE group, and both VRE and ESBL-producing bacterial colonization cases in which early-onset sepsis occurred resulted in neonatal death. The prognosis of cervical VRE colonization after cervical surgery was poor, whereas the prognosis of ESBL-producing bacterial colonization in the cervix did not differ significantly from that of the control group. However, careful neonatal treatment is required considering that early-onset sepsis is fatal to the newborn.

scholarly journals Nursing-Home Patient Functional and Microbiota Status Drive Environmental Contamination with Vancomycin-Resistant Enterococci

2021 ◽  
Vol 1 (S1) ◽  
pp. s68-s68
Author(s):  
Joyce Wang ◽  
Betsy Foxman ◽  
A. Krishna Rao ◽  
Lona Mody ◽  
Evan Snitkin
Keyword(s):  
Nursing Homes ◽  
Gut Microbiota ◽  
Functional Status ◽  
Environmental Contamination ◽  
Functional Dependence ◽  
Patient Factors ◽  
High Functioning ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant

Background: Patient colonization and shedding of vancomycin-resistant enterococci (VRE) is a major source of environmental contamination leading to VRE transmission in nursing homes. We hypothesize that we can inform mitigation strategies by identifying patient clinical and microbiota features associated with environmental contamination with VRE. Methods: During a 6-month period of active surveillance in 6 Michigan nursing homes, 245 patients (with 806 follow-up visits) were enrolled. Patient clinical data and swabs for VRE were collected from multiple body sites and high-touch environmental surfaces. In total, 316 perirectal swabs were collected from 137 patients for gut microbiota analysis and community status type (CST) assignment based on taxonomic composition. The associations between VRE colonization pattern, gut microbial CST, and patient factors were examined using multivariable generalized estimating equations, adjusting for patient-and facility-level clustering. We used VRE colonization patterns to group study visits: “uncolonized” (patient−/environment−); “environment-only” (patient−/environment+); “patient-only” (patient+/environment−); “both” (patient+/environment+). Results: Across all study visits, VRE colonization on patient hand and groin/perirectal area was positively correlated with VRE contamination of high-touch environmental surfaces, suggesting direct transfer of VRE between patient and environment via patient hands (Figure 1A). We next set out to identify patient factors associated with patient colonization and environmental contamination. At baseline, while patients in the “both” group had anticipated risk factors such as longer prior hospitalization and more frequent broad-spectrum antibiotic use, they were unexpectedly younger than “uncolonized” patients and had similar functional status. This last feature contrasted with the “patient-only” group, characterized by higher urinary catheter use and higher functional dependence, suggestive of lower functional dependence facilitating patient contamination of their environment. No clinical features distinguished “uncolonized” and “environment-only” patients (Table 1). Lastly, in multivariable analyses, we determined the contribution of patient functional status and gut microbiota features to environmental contamination. Low-diversity CST, characterized by reduced anaerobic taxa, was weakly associated with “patient-only” and significantly associated with “both.” Notably, high functional dependence was significantly associated with “environment-only” and “patient-only” but not “both,” indicating high-functioning patients with disrupted gut microbiota as drivers of environmental contamination (Figure 1B). Conclusions: Our findings suggest that antimicrobial exposure disrupts patient gut microbiota, a significant mediator of colonization dynamics between patients and their environment, and that high-functioning patients may be more likely to spread VRE between their body sites and high-touch environmental surfaces (Figure 2). These findings highlight both antibiotic stewardship and patient hand hygiene as important targets for interrupting transmission mediated by environmental contamination.Funding: NoDisclosures: None

scholarly journals A Comparison of Environmental Contamination by Patients Infected or Colonized with Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci: A Multicenter Study

2014 ◽  
Vol 35 (7) ◽  
pp. 872-875 ◽  
Author(s):  
Lauren P. Knelson ◽  
David A. Williams ◽  
Maria F. Gergen ◽  
William A. Rutala ◽  
David J. Weber ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Multicenter Study ◽  
Environmental Contamination ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Interquartile Range ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Colony Forming Units ◽  
Vancomycin Resistant

A total of 1,023 environmental surfaces were sampled from 45 rooms with patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) before terminal room cleaning. Colonized patients had higher median total target colony-forming units (CFU) of MRSA or VRE than did infected patients (median, 25 CFU [interquartile range, 0–106 CFU] vs 0 CFU [interquartile range, 0–29 CFU]; P = .033).Infect Control Hosp Epidemiol 2014;35(7):872–875

scholarly journals Detection of Methicillin-ResistantStaphylococcus aureusand Vancomycin-Resistant Enterococci on the Gowns and Gloves of Healthcare Workers

2008 ◽  
Vol 29 (7) ◽  
pp. 583-589 ◽  
Author(s):  
Graham M. Snyder ◽  
Kerri A. Thorn ◽  
Jon P. Furuno ◽  
Eli N. Perencevich ◽  
Mary-Claire Roghmann ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Tertiary Care ◽  
Routine Care ◽  
Inpatient Setting ◽  
Jejunostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Vancomycin Resistant Enterococci ◽  
Increased Risk ◽  
Vancomycin Resistant

Objective.To assess the rate of and the risk factors for the detection of methicillin-resistantS. aureus(MRSA) and vancomycin-resistant enterococci (VRE) on the protective gowns and gloves of healthcare workers (HCWs).Methods.We observed the interactions between HCWs and patients during routine clinical activities in a 29-bed medical intensive care unit at the University of Maryland Medical Center, an urban tertiary care academic hospital. Samples for culture were obtained from HCWs' hands prior to their entering a patient's room, from HCWs' disposable gowns and gloves after they completed patient care activities, and from HCWs' hands immediately after they removed their protective gowns and gloves.Results.Of 137 HCWs caring for patients colonized or infected with MRSA and/or VRE, 24 (17.5%; 95% confidence interval, 11.6%–24.4%) acquired the organism on their gloves, gown, or both. HCW contact with the endotracheal tube or tracheostomy site of a patient (P< .05), HCW contact with the head and/or neck of a patient (P< .05), and HCW presence in the room of a patient with a percutaneous endoscopic gastrostomy and/or jejunostomy tube (P< .05) were associated with an increased risk of acquiring these organisms.Conclusions.The gloves and gowns of HCWs frequently become contaminated with MRSA and VRE during the routine care of patients, and particularly during care of the patient's respiratory tract and any associated indwelling devices. As part of a larger infection control strategy, including high-compliance hand disinfection, they likely provide a useful barrier to transmitting antibiotic-resistant organisms among patients in an inpatient setting.

Recovery of Vancomycin-Resistant Enterococci on Fingertips and Environmental Surfaces

1995 ◽  
Vol 16 (10) ◽  
pp. 577-581 ◽  
Author(s):  
Gary A. Noskin ◽  
Valentina Stosor ◽  
Isabell Cooper ◽  
Lance R. Peterson
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant

Recovery of Vancomycin-Resistant Enterococci on Fingertips and Environmental Surfaces

1995 ◽  
Vol 16 (10) ◽  
pp. 577-581 ◽  
Author(s):  
Gary A. Noskin ◽  
Valentina Stosor ◽  
Isabell Cooper ◽  
Lance R. Peterson
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant

scholarly journals Comparison of the Rodac Imprint Method to Selective Enrichment Broth for Recovery of Vancomycin-Resistant Enterococci and Drug-Resistant Enterobacteriaceae from Environmental Surfaces

2000 ◽  
Vol 38 (12) ◽  
pp. 4646-4648 ◽  
Author(s):  
Donna M. Hacek ◽  
William E. Trick ◽  
Susan M. Collins ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Amphotericin B ◽  
Brain Heart Infusion ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Enrichment Broth ◽  
Selective Enrichment ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant ◽  
Selective Enrichment Broth

We compared the Rodac imprint technique to selective enrichment broth for detecting vancomycin-resistant enterococci (VRE) and multidrug-resistant Enterobacteriaceae (MDRE) on surfaces. Rodac plates contained tryptic soy agar with 5% sheep blood, vancomycin (6 μg/ml), ceftazidime (2 μg/ml), amphotericin B (2 μg/ml), and clindamycin (1 μg/ml). Two types of broth were used: brain heart infusion (BHI) and BHI plus vancomycin (6 μg/ml) and ceftazidime (2 μg/ml) (BHIVC). Of the 46 surfaces cultured for VRE, 12 (26%) were positive. Of the 12 VRE-positive surfaces, 11 (92%) grew from Rodac, 8 (67%) grew from BHIVC, and 7 (58%) grew from BHI. A larger study is needed for MDRE, as only 4 of 43 surfaces were MDRE positive. The Rodac imprint technique successfully recovered VRE from environmental surfaces.

Skin and Environmental Contamination With Vancomycin-Resistant Enterococci in Patients Receiving Oral Metronidazole or Oral Vancomycin Treatment forClostridium difficile–Associated Disease

2009 ◽  
Vol 30 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Ajay K. Sethi ◽  
Wafa N. Al-Nassir ◽  
Michelle M. Nerandzic ◽  
Curtis J. Donskey
Keyword(s):  
Fecal Incontinence ◽  
Environmental Contamination ◽  
Prospective Observational Study ◽  
Medical Center ◽  
Veterans Affairs ◽  
Vancomycin Resistant Enterococci ◽  
Before And After ◽  
Vancomycin Resistant ◽  
Vancomycin Treatment ◽  
Oral Metronidazole

Background.Oral metronidazole has been recommended for treatment of mild-to-moderateClostridium difficile–associated disease (CDAD), in part because of concern that use of vancomycin may be more likely to promote colonization and transmission of vancomycin-resistant enterococci (VRE). The objective of our study was to compare the frequency of skin and environmental VRE contamination associated with metronidazole treatment for CDAD with such frequency associated with vancomycin treatment for CDAD.Design.Prospective, observational study. This study was performed at the Cleveland Veterans Affairs Medical Center (Cleveland, OH). For patients with CDAD who had concurrent VRE colonization, stool, skin, and environmental samples were cultured for VRE before, during, and up to 3 weeks after therapy with metronidazole or vancomycin. The proportions of skin and environmental contamination were compared before and after resolution of diarrhea and during treatment with metronidazole or vancomycin.Results.Of the 34 patients, 17 were treated with vancomycin and 17 were treated with metronidazole. The proportion of environmental cultures that were positive for VRE was significantly higher during resolution of diarrhea than it was after resolution of diarrhea (38% vs 28%;P= .025), whereas the proportion of skin cultures positive was not different during and after resolution of diarrhea (78% vs 71%;P= .60). There were no differences between patients who received metronidazole and patients who received vancomycin in the proportions of skin culture results (73% vs 77%;P= .80) or environmental culture results (37% vs 32%;P= .359) that were positive for VRE. Eleven patients (32%) had chronic fecal incontinence, and 28 (82%) had incontinence at least once during their CDAD episode.Conclusions.In VRE-colonized patients with CDAD who experienced frequent fecal incontinence, skin and environmental VRE contamination was common during and after resolution of diarrhea. The frequency of VRE contamination was similar between patients treated with metronidazole and patients treated with vancomycin.

scholarly journals Impact of an Environmental Cleaning Intervention on the Presence of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci on Surfaces in Intensive Care Unit Rooms

2008 ◽  
Vol 29 (7) ◽  
pp. 593-599 ◽  
Author(s):  
Eric R. Goodman ◽  
Richard Piatt ◽  
Richard Bass ◽  
Andrew B. Onderdonk ◽  
Deborah S. Yokoe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Odds Ratio ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Black Light ◽  
Environmental Surfaces ◽  
Vancomycin Resistant ◽  
Cleaning Intervention

Objectives.To evaluate the adequacy of discharge room cleaning and the impact of a cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) on environmental surfaces in intensive care unit (ICU) rooms.Design.Prospective environmental study.Setting and sample.Convenience sample of ICU rooms in an academic hospital.Methods and intervention.The intervention consisted of (1) a change from the use of pour bottles to bucket immersion for applying disinfectant to cleaning cloths, (2) an educational campaign, and (3) feedback regarding adequacy of discharge cleaning. Cleaning of 15 surfaces was evaluated by inspecting for removal of a preapplied mark, visible only with an ultraviolet lamp (“black light”). Six surfaces were cultured for MRSA or VRE contamination. Outcomes of mark removal and culture positivity were evaluated by X2 testing and generalized linear mixed models, clustering by room.Results.The black-light mark was removed from 44% of surfaces at baseline, compared with 71 % during the intervention (P < .001). The intervention increased the likelihood of removal of black-light marks after discharge cleaning (odds ratio, 4.4; P < .001), controlling for ICU type (medical vs surgical) and type of surface. The intervention reduced the likelihood of an environmental culture positive for MRSA or VRE (proportion of cultures positive, 45% at baseline vs 27% during the intervention; adjusted odds ratio, 0.4; P = .02). Broad, flat surfaces were more likely to be cleaned than were doorknobs and sink or toilet handles.Conclusions.Increasing the volume of disinfectant applied to environmental surfaces, providing education for Environmental Services staff, and instituting feedback with a black-light marker improved cleaning and reduced the frequency of MRSA and VRE contamination.

Potential impact of removing metronidazole from treatment armamentarium of mild acute Clostridioides difficile infection

2019 ◽  
Vol 14 (17) ◽  
pp. 1489-1495 ◽  
Author(s):  
Shani Zilberman-Itskovich ◽  
Ilan Youngster ◽  
Tsilia Lazarovitch ◽  
Marina Bondarenco ◽  
Limor Toledano ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Medical Center ◽  
Therapeutic Option ◽  
Clostridioides Difficile ◽  
Vancomycin Resistant Enterococci ◽  
Clostridioides Difficile Infection ◽  
Multivariable Analyses ◽  
Vancomycin Resistant ◽  
Potential Impact ◽  
Independent Association

Aim: Recent guidelines recommended removing metronidazole as a therapeutic option for Clostridioides difficile infections (CDI). However, superiority of vancomycin over metronidazole in mild CDI is not established and use of vancomycin might lead to emergence of vancomycin-resistant enterococci (VRE). Patients & methods: A retrospective cohort study and efficacy analyses were conducted at Shamir Medical Center, Israel (2010–2015), among adults with acute CDI. Results: A total of 409 patients were enrolled. In multivariable analyses, metronidazole was noninferior to vancomycin for mild CDI, but vancomycin was an independent predictor for post-CDI VRE acquisition. Conclusion: A significant independent association was evident between treatment with vancomycin and, later, acquisition of VRE. In first episodes of mild acute CDI, metronidazole should be considered a valid therapeutic option.

Sign in / Sign up

Export Citation Format

Share Document