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VRE in ICU patients

Petra Gastmeier, Klaus-Peter Kämpf, Michael Behnke, Christine Geffers, Frank Schwab
OBJECTIVES: To investigate the effect of universal decolonization with octenidine on the incidence of ICU-acquired bloodstream infections (BSI) and MDR organisms (MDRO). METHODS: A system-wide change in practice was performed in the ICUs of a university hospital with three campuses (eight medical ICUs and nine surgical ICUs). All ICUs had a general admission screening strategy for MRSA with subsequent isolation in the 12 month baseline period, which was stopped...
September 2016: Journal of Antimicrobial Chemotherapy
Patrick McGann, Jessica L Bunin, Erik Snesrud, Seema Singh, Rosslyn Maybank, Ana C Ong, Yoon I Kwak, Scott Seronello, Robert J Clifford, Mary Hinkle, Stephen Yamada, Jason Barnhill, Emil Lesho
Whole genome sequencing (WGS) is increasingly employed in clinical settings, though few assessments of turnaround times (TAT) have been performed in real-time. In this study, WGS was used to investigate an unfolding outbreak of vancomycin resistant Enterococcus faecium (VRE) among 3 patients in the ICU of a tertiary care hospital. Including overnight culturing, a TAT of just 48.5 h for a comprehensive report was achievable using an Illumina Miseq benchtop sequencer. WGS revealed that isolates from patient 2 and 3 differed from that of patient 1 by a single nucleotide polymorphism (SNP), indicating nosocomial transmission...
July 2016: Diagnostic Microbiology and Infectious Disease
J A McKINNELL, D F Kunz, S A Moser, S Vangala, C-H Tseng, M Shapiro, L G Miller
Vancomycin-resistant enterococci (VRE) infections are a public health threat associated with increased patient mortality and healthcare costs. Antibiotic usage, particularly cephalosporins, has been associated with VRE colonization and VRE bloodstream infections (VRE BSI). We examined the relationship between antimicrobial usage and incident VRE colonization at the individual patient level. Prospective, weekly surveillance was undertaken for incident VRE colonization defined by negative admission but positive surveillance swab in a medical intensive care unit over a 17-month period...
June 2016: Epidemiology and Infection
Kristen V Dicks, Eric Lofgren, Sarah S Lewis, Rebekah W Moehring, Daniel J Sexton, Deverick J Anderson
OBJECTIVE To determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). DESIGN Interrupted time series analysis. SETTING The study included 33 community hospitals participating in the Duke Infection Control Outreach Network from January 2008 through December 2013. PARTICIPANTS All ICU patients at study hospitals during the study period...
July 2016: Infection Control and Hospital Epidemiology
Pedro G Vianna, Charles R Dale, Sarah Simmons, Mark Stibich, Carmelo M Licitra
BACKGROUND: The role of contaminated environments in the spread of hospital-associated infections has been well documented. This study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility. METHODS: This study was conducted in a community hospital in Southern Florida. Beginning November 2012, a pulsed xenon ultraviolet disinfection system was implemented as an adjunct to traditional cleaning methods on discharge of select rooms...
March 1, 2016: American Journal of Infection Control
Kesavaram Padmavathy, Shabana Praveen, Radha Madhavan, Nagarajan Krithika, Alexander Kiruthiga
Prolonged hospitalization and exposure to third generation cephalosporins are reported to facilitate the acquisition and colonization of Vancomycin Resistant Enterococci (VRE). Though VRE is not uncommon in India, urinary tract infection with a vanA genotype is a cause of serious concern as VRE co-exhibit resistance to aminoglycosides. In India, majority of the VRE isolates recovered from hospitalized patients include Enterococcus faecium. We report a case of catheter associated urinary tract infection by an endogenous, multidrug resistant E...
August 2015: Journal of Clinical and Diagnostic Research: JCDR
Aslınur Özkaya-Parlakay, Ali Bülent Cengiz, Mehmet Ceyhan, Arzu Bağdat, Çağrı Barın-Kurtoğlu, Venhar Gürbüz, Ahmet Emre Aycan, Ateş Kara
Vancomycin-resistant enterococci (VRE) have become a major concern in medical practice. Asymptomatic VRE colonization of the gastrointestinal tract may lead to infection. In this study, which included patients who stayed in our hospital between 2006 and 2011, we looked at the cases of 342 patients with VRE colonization and 19 patients with VRE infection. Vancomycin and carbapenem exposure and intestinal disorders were significantly more common in patients with VRE infection than in those with VRE colonization (p=0...
November 2014: Turkish Journal of Pediatrics
Zuhal Yeşilbağ, Arif Atahan Çağatay, Aslı Karadeniz, Seniha Başaran, Günseli Orhun, Perihan Ergin Özcan, Halit Özsüt, Haluk Eraksoy
Nosocomial infections caused by multidrug-resistant (MDR) microorganisms are a major problem in intensive care units (ICUs) with high mortality and morbidity rates and the prior colonization is an important risk factor for these infections. The aim of this study was to investigate the prevalence of rectal colonization of MDR microorganisms and the association between the microorganisms that caused colonization and infection in the patients with nosocomial infections in ICUs. Rectal swabs were obtained on the day of 0, 3, 7, 14, 21 and weekly thereafter from 80 patients over 18 years of age hospitalized in ICU for more than 48 hours, and cultured for vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase (ESBL)- producing gram-negative bacilli (GNB) and carbapenem-resistant enteric and nonenteric bacilli...
July 2015: Mikrobiyoloji Bülteni
David M Lister, Despina Kotsanas, Susan A Ballard, Benjamin P Howden, Elizabeth Carse, Kenneth Tan, Carmel Scott, Elizabeth E Gillespie, Andrew A Mahony, Richard Doherty, Tony M Korman, Paul D R Johnson, Rhonda L Stuart
OBJECTIVE: To describe successful termination of an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) colonization within a neonatal service. SETTING: Multisite neonatal intensive care unit and special care nurseries within a single health care service. PARTICIPANTS: Forty-four cases of VREfm-colonized neonatal inpatients-including 2 clinical isolates (eye swab and catheter-urine specimen) and 42 screening isolates. INTERVENTIONS: Active surveillance cultures, patient isolation, contact precautions, enhanced environment cleaning, and staff and parent education...
October 1, 2015: American Journal of Infection Control
Christopher A Guidry, Stephen W Davies, Rosemarie Metzger, Brian R Swenson, Robert G Sawyer
BACKGROUND: Antimicrobial resistance results from a complex interaction between pathogenic and non-pathogenic bacteria, antimicrobial pressure, and genes, which together comprise the total body of potential resistance elements. The purpose of this study is to review and evaluate the importance of antimicrobial pressure on the development of resistance in a single surgical intensive care unit. METHODS: We reviewed a prospectively collected dataset of all intensive care unit (ICU)-acquired infections in surgical and trauma patients over a 6-y period at a single hospital...
December 2015: Surgical Infections
M Papadimitriou-Olivgeris, I Spiliopoulou, M Christofidou, D Logothetis, P Manolopoulou, V Dodou, F Fligou, M Marangos, E D Anastassiou
Our goal was to identify the risk factors for co-colonization by KPC-producing Klebsiella pneumoniae (KPC-Kp), vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) upon intensive care unit (ICU) admission and during stay. Rectal and nasal samples were taken from each patient upon admission at two Greek ICUs and each week afterwards, and were inoculated onto chromogenic agar. Representative colonies were characterized with standard methods and Vitek-2 technology. The presence of the bla KPC gene (K...
October 2015: European Journal of Clinical Microbiology & Infectious Diseases
Marcell Szabó, Anna Bozó, Sándor Soós, Katalin Darvas, László Harsányi, Ákos Csomós
INTRODUCTION: Enterococci have increasing importance in intensive care units, and vancomycin-resistant strains express a new challenge. AIM: The aim of the authors was to present their findings obtained from the first vancomycin-resistant enterococci outbreak occurred in 2013 at the Intensive Care Unit of the 1st Department of Surgery, Semmelweis University. METHOD: This was a case-control study of patients who had Enterococci species isolated from their microbiological samples between January 1 and June 30, 2013...
May 10, 2015: Orvosi Hetilap
Pamela A Moise, George Sakoulas, James A McKinnell, Kenneth C Lamp, Daryl D DePestel, Min J Yoon, Katherine Reyes, Marcus J Zervos
PURPOSE: In light of recent evidence suggesting enhancement of daptomycin activity against vancomycin-resistant Enterococcus (VRE) by ampicillin and other β-lactam antibiotics, we evaluated the safety profile and clinical efficacy of daptomycin with and without concomitant β-lactam antimicrobials in the treatment of VRE (faecium or faecalis) bacteremia from multiple centers across the United States. METHODS: Data were collected retrospectively as part of a larger multicenter registry (The Cubicin Outcomes Registry and Experience)...
July 1, 2015: Clinical Therapeutics
Calvin Williams, Patty McGraw, Elyse E Schneck, Anna LaFae, Jesse T Jacob, Daniela Moreno, Katherine Reyes, G Fernando Cubillos, Daniel H Kett, Ronald Estrella, Daniel J Morgan, Anthony D Harris, Marci Drees
OBJECTIVE: To determine whether gowning and gloving for all patient care reduces contamination of healthcare worker (HCW) clothing, compared to usual practice. DESIGN: Cross-sectional surveys. SETTING: Five study sites were recruited from intensive care units (ICUs) randomized to the intervention arm of the Benefits of Universal Gown and Glove (BUGG) study. PARTICIPANTS: All HCWs performing direct patient care in the study ICUs were eligible to participate...
April 2015: Infection Control and Hospital Epidemiology
Burcu Dalyan Cilo, Harun Ağca, Kadir Efe, Melda Sınırtaş, Solmaz Çelebi, Hilal Özkan, Nilgün Köksal, Mustafa Hacımustafaoğlu, Cüneyt Özakın
Enterococci are one of the major agents of community-acquired and nosocomial infections. In this study we aimed to analyze the clonal relation of the vancomycin-resistant Enterococci outbreak seen at the Neonate Intensive Care Unit (NICU) of Uludag University Hospital. Vancomycin resistance gene was investigated in the Enterococcus faecium strains and pulsed field gel electrophoresis (PFGE) was used to investigate the genetic relation between outbreak strains. Enterococci grown in all patient samples were identified as Enterococcus faecium by BD Phoenix 100 (Becton Dickinson, USA)...
2014: International Journal of Clinical and Experimental Medicine
Nonika Rajkumari, Purva Mathur, Mahesh Chandra Misra
Soft tissue and wound infections due to Enterococcus spp. are increasing worldwide with current need to understand the epidemiology of the Enterococcal infections of wounds. Hence, we have looked into the distribution of Enterococcus spp. responsible for causing wound and soft tissue infections among trauma patients, its antibiotic resistance pattern and how it affects the length of hospital stay and mortality. A laboratory cum clinical-based study was performed over a period of 3 years at a level I trauma center in New Delhi, India...
October 2014: Journal of Global Infectious Diseases
Sudha P Jayaraman, Reza Askari, Molli Bascom, Xiaoxia Liu, Selwyn O Rogers, Michael Klompas
BACKGROUND: There were two major outbreaks of multi-drug resistant Acinetobacter baumannii (MDRA) in our general surgery and trauma intensive care units (ICUs) in 2004 and 2011. Both required aggressive multi-faceted interventions to control. We hypothesized that the infection control response may have had a secondary benefit of reducing rates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile (C. diff). METHODS: We analyzed data retrospectively from a prospective infection control database at a major university hospital and calculated the incidence rates of nosocomial MRSA, VRE, and C...
December 2014: Surgical Infections
Hatice Uludağ Altun, Ciğdem Ataman Hatipoğlu, Cemal Bulut, Ozgen Köseoğlu Eser, Ali Pekcan Demiröz
Vancomycin-resistant enterococci (VRE) are important agents of hospital infections worldwide. Early recognition of VRE colonization is important in the control of hospital infections. The aim of this study was to compare a real-time PCR (Rt-PCR) system and culture methods in the detection of VRE colonization. A total of 210 perirectal swab samples obtained from the patients (142 were in internal and 68 were in surgical intensive care units) hospitalized at Ankara Training and Research Hospital, Turkey between January-September 2013 were included in the study...
October 2014: Mikrobiyoloji Bülteni
Linda McKinley, Helene Moriarty, Thomas H Short, Mary Hagle, Abigail Ranum, Susan Valentine, Nasia Safdar
Screening for vancomycin-resistant Enterococcus (VRE) has not been universally implemented within the Department of Veterans Affairs (VA). A prospective study was conducted to identify the admission prevalence rate of VRE in patients admitted to the intensive care unit in 2 VA facilities. Significant regional differences were found between the 2 facilities. Further studies are needed to account for regional differences in VRE admission prevalence, to optimize infection control interventions.
November 2014: American Journal of Infection Control
Cristina Vazquez-Guillamet, Marin H Kollef
Gram-positive bacteria to include methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus aureus (MSSA), and enterococci, to include vancomycin-resistant enterococci (VRE), display a remarkable array of resistance and virulence factors, which have contributed to their prominent role in infections of the critically ill. Over the last three decades infections with these pathogens has increased as has their overall resistance to available antimicrobial agents. This has led to the development of a number of new antibiotics for the treatment of Gram-positive bacteria...
2014: BMC Infectious Diseases
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