Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-20T05:42:17.141Z Has data issue: false hasContentIssue false

Undetected Vancomycin-Resistant Enterococcus Stool Colonization in a Veterans Affairs Hospital Using a Clostridium difficile–Focused Surveillance Strategy

Published online by Cambridge University Press:  02 January 2015

Amy J. Ray
Affiliation:
University Hospitals of Cleveland
Claudia K. Hoyen
Affiliation:
Rainbow Babies and Children's Hospital, Cleveland, Ohio
Sarbani M. Das
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
Elizabeth C. Eckstein
Affiliation:
Infection Control Department, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
Curtis J. Donskey*
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
*
Infectious Diseases Section, Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Blvd., Cleveland, OH 44106

Abstract

We examined the point prevalence of undetected vancomycin-resistant Enterococcus (VRE) stool colonization in an institution that screens stool samples submitted for Clostridium difficile testing. Of 112 patients not known to be colonized, 10 (9%) had rectal VRE colonization. A prospective algorithm was effective for identification of colonized patients.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Donskey, CJ, Chowdhry, TK, Hecker, MT, et al. Effect of antibiotic therapy on the density of vancomycin-resistant enterococci in the stool of colonized patients. N Engl J Med 2000;343:19251932.CrossRefGoogle Scholar
2.Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105113.Google Scholar
3.Katz, KC, Gardam, MA, Burt, J, Conly, JM. A comparison of multifaceted versus Clostridium difficile–focused VRE surveillance strategies in a low-prevalence setting. Infect Control Hosp Epidemiol 2001;22:219221.Google Scholar
4.Leber, AL, Hindier, JF, Kato, EO, Bruckner, DA, Pegues, DA. Laboratory-based surveillance for vancomycin-resistant enterococci: utility of screening stool specimens submitted for Clostridium difficile toxin assay. Infect Control Hosp Epidemiol 2001;22:160164.Google Scholar
5.Garbutt, JM, Littenberg, B, Evanoff, BA, Sahm, D, Mundy, LM. Enteric carriage of vancomycin-resistant Enterococcus faecium in patients tested for Clostridium difficile. Infect Control Hosp Epidemiol 1999;20:664670.CrossRefGoogle ScholarPubMed
6.Hacek, DM, Bednarz, P, Noskin, GA, Zembower, T, Peterson, LR. Yield of vancomycin-resistant enterococci and multidrug-resistant Enterobacteriaceae from stools submitted for Clostridium difficile testing compared to results from a focused surveillance program. J Clin Microbiol 2001;39:11521154.Google Scholar
7.Rafferty, ME, McCormick, MI, Bopp, LH, et al. Vancomycin-resistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay. Infect Control Hosp Epidemiol 1997;18:342344.Google Scholar
8.National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Wayne, PA: National Committee for Clinical Laboratory Standards; 1993:M7A3.Google Scholar
9.Boyce, JM, Mermel, LA, Zervos, JM, et al. Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1995;16:634637.Google Scholar
10.D'Agata, EMC, Gautam, S, Green, WK, Tang, Y-W. High rate of false-negative results of the rectal swab culture method in detection of gastrointestinal colonization with vancomycin-resistant enterococci. Clin Infect Dis 2002;34:167172.Google Scholar