Control of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region

Authors

Belinda E. Ostrowsky , M.D., M.P.H., Virginia Commonwealth University, National Center for Infectious DiseasesFollow
William E. Trick, National Center for Infectious Diseases
Annette H. Sohn, National Center for Infectious Diseases
Stephen B. Quirk, Siouxland District Health Department
Stacey Holt , B.S., Center for Infectious Diseases
Loretta A. Carson , M.S., National Center for Infectious Diseases
Bertha C. Hill, National Center for Infectious Diseases
Mathew J. Arduino, National Center for Infectious Diseases
Mathew J. Kuehnert, Epidemiology Program Office
William R. Jarvis, National Center for Infectious Diseases

Document Type

Article

Original Publication Date

2001

Journal/Book/Conference Title

The New England Journal of Medicine

Volume

344

DOI of Original Publication

10.1056/NEJM200105103441903

Comments

Originally Published at http://dx.doi.org/10.1056/NEJM200105103441903

Date of Submission

January 2015

Abstract

Background

In late 1996, vancomycin-resistant enterococci were first detected in the Siouxland region of Iowa, Nebraska, and South Dakota. A task force was created, and in 1997 the assistance of the Centers for Disease Control and Prevention was sought in assessing the prevalence of vancomycin-resistant enterococci in the region’s facilities and implementing recommendations for screening, infection control, and education at all 32 health care facilities in the region.

Methods

The infection-control intervention was evaluated in October 1998 and October 1999. We performed point-prevalence surveys, conducted a case– control study of gastrointestinal colonization with vancomycin-resistant enterococci, and compared infection-control practices and screening policies for vancomycin-resistant enterococci at the acute care and long-term care facilities in the Siouxland region.

Results

Perianal-swab samples were obtained from 1954 of 2196 eligible patients (89 percent) in 1998 and 1820 of 2049 eligible patients (89 percent) in 1999. The overall prevalence of vancomycin-resistant enterococci at 30 facilities that participated in all three years of the study decreased from 2.2 percent in 1997 to 1.4 percent in 1998 and to 0.5 percent in 1999 (P

Conclusions

An active infection-control intervention, which includes the obtaining of surveillance cultures and the isolation of infected patients, can reduce or eliminate the transmission of vancomycinresistant enterococci in the health care facilities of a region. (N Engl J Med 2001;344:1427-33.)

Rights

From The New England Journal of Medicine, Ostrowsky, B. E., Trick, W. E., Sohn, A. H. et al., CONTROL OF VANCOMYCIN-RESISTANT ENTEROCOCCUS IN HEALTH CARE FACILITIES IN A REGION, Vol. 344, Page 1427, Copyright © 2001 Massachusetts Medical Society. Reprinted with permission.

Is Part Of

VCU Medical Center Publications