Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-28T16:03:41.875Z Has data issue: false hasContentIssue false

A Comparison of Multifaceted Versus Clostridium difficile-Focused VRE Surveillance Strategies in a Low-Prevalence Setting

Published online by Cambridge University Press:  02 January 2015

Kevin C. Kate
Affiliation:
Infection Prevention and Control Unit, Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
Michael A. Gardam
Affiliation:
Infection Prevention and Control Unit, Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
JoAnne Burt
Affiliation:
Infection Prevention and Control Unit, Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
John M. Conly*
Affiliation:
Infection Prevention and Control Unit, Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
*
Infection Prevention and Control Unit, University Health Network, NU 13-118, Toronto General Hospital, 585 University Ave, Toronto ON M5G 2C4, Canada

Abstract

We compared our current screening strategy for vancomycin-resistant Enterococcus (VRE) with a focused strategy that screens all stool samples sent for Clostridium difficile toxin assay but limits rectal swab screening to wards with new VRE cases detected via C difficile samples. The proposed strategy detects 72.7% of new VRE cases, with substantial cost savings.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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. Conly, JM, Ofner, ME, Paton, S. The emerging epidemiology of vancomycin resistant enterococci in Canada, 1993-1998: results from the Canadian Nosocomial Infection Surveillance Program (CNISP) passive reporting network. Can J Infect Dis 1999;10(suppl D):38D.Google Scholar
2. Centers for Disease Control and Prevention. Recommendations for preventing the spread of vancomycin resistance. Hospital Infection Control Practices Advisory Committee. MMWR 1995;44(RR-12):113.Google Scholar
3. Weinstein, MR, Dedier, H, Brunton, J, Campbell, I, Conly, JM. Lack of efficacy of oral bacitracin plus doxycycline for the eradication of stool colonization with vancomycin-resistant Enterococcus faecium . Clin Infect Dis 1999;29:361366.Google Scholar
4. Montecalvo, M, de Lencastre, H, Carraher, M, Gedris, C, Chung, M, VanHorn, K, et al. Natural history of colonization with vancomycin-resistant Enterococcus faecium . Infect Control Hosp Epidemiol 1995;16:680685.Google Scholar
5. Facklam, RR, Collins, MD. Identification of Enterococcus species isolated from human infections by a conventional test scheme. J Clin Microbiol 1989;27:731734.Google Scholar
6. Rosner, B. Fundamentals of Biostatistics. 3rd ed. Boston, MA: PWS-Kent Pubs Co; 1990:366372.Google Scholar
7. Roghmann, MC, McCarter, RJ, Brewrink, J, Cross, AS, Morris, JG. Clostridium difficile infection is a risk factor for bacteremia due to vancomycin-resistant enterococci (VRE) in VRE-colonized patients with acute leukemia. Clin Infect Dis 1997;25:10561059.Google Scholar
8. Gerding, D. Is there a relationship between vancomycin-resistant enterococcal infection and Clostridium difficile infection? Clin Infect Dis 1997;25(suppl 2):S206S210.Google Scholar
9. Rafferty, ME, McCormick, MI, Bopp, LH, Baltch, AL, George, M, Smith, RP, et al. Vancomycin-resistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay. Infect Control Hosp Epidemiol 1997;18:342344.Google Scholar
10. Boyce, JM, Mermel, LA, Zervos, JM, Rice, L, Potter-Bynoe, G, Giorgio, C, et al. Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1995;16:634637.Google Scholar