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Colonization and Infection With Multiple Nosocomial Pathogens Among Patients Colonized With Vancomycin-Resistant Enterococcus

Published online by Cambridge University Press:  02 January 2015

Curtis J. Donskey ,
Amy J. Ray ,
Claudia K. Hoyen ,
Peter D. Fuldauer ,
David C. Aron ,
Ann Salvator  and
Robert A. Bonomo
Curtis J. Donskey*
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
Amy J. Ray
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
Claudia K. Hoyen
Affiliation:
Division Infectious Diseases, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Peter D. Fuldauer
Affiliation:
Microbiology Department, MetroHealth Medical Center, Cleveland, Ohio
David C. Aron
Affiliation:
Center for Quality Improvement Research, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
Ann Salvator
Affiliation:
Division Infectious Diseases, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Robert A. Bonomo
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
*
Louis Stokes Cleveland VA Medical Center, Infectious Diseases Section (111W), 10701 Blvd., Cleveland, OH 44106
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Abstract

Objective:

To test the hypothesis that patients colonized with vancomycin-resistant Enterococcus (VRE) have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE.

Design:

A rectal swab culture survey was conducted to determine the point-prevalence of stool colonization with ceftazidime-resistant gram-negative bacilli in hospitalized patients with or without VRE stool colonization. For a 6-month period, the frequency of Clostridium difficile diarrhea and isolation of antibiotic-resistant (ie, ceftazidime-, piperacillin/tazobactam-, levofloxacin-, or trimethoprim/sulfamethoxazole-resistant) gram-negative bacilli, methicillin-resistant Staphylococcus aureus (MRSA), and non-albicans Candida species from clinical specimens other than stool was examined.

Setting:

A Department of Veterans Affairs medical center.

Patients:

All patients hospitalized in the acute care facility and one nursing home unit during a 1-week period in February 2001.

Results:

VRE-colonized patients had a higher point-prevalence of rectal colonization with ceftazidime-resistant gram-negative bacilli than did patients not colonized with VRE (17% vs 4%; P = .026). During a 6-month period, the VRE-colonized patients were more likely to have Clostridium difficile–associated diarrhea (26% vs 2%; P = .001), MRSA infection (17% vs 4%; P = .017), or colonization or infection with gram-negative bacilli resistant to 4 different antibiotics.

Conclusion:

VRE-colonized patients in our institution have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE. This suggests that isolation measures implemented to control VRE could help limit the dissemination of other, coexisting pathogens.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 4 , April 2003 , pp. 242 - 245
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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