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Control of Vancomycin-Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting

Published online by Cambridge University Press:  02 January 2015

Elise M. Jochimsen ,
Laurie Fish ,
Kelly Manning ,
Sally Young ,
Daniel A. Singer ,
Robert Baker  and
William R. Jarvis
Elise M. Jochimsen*
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Laurie Fish
Affiliation:
Community Hospital East, Indianapolis, Indiana
Kelly Manning
Affiliation:
Community Hospital East, Indianapolis, Indiana
Sally Young
Affiliation:
Community Hospital East, Indianapolis, Indiana
Daniel A. Singer
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Robert Baker
Affiliation:
Community Hospital East, Indianapolis, Indiana
William R. Jarvis
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Hospital Infections Program, Mailstop E-69, Centers for Disease Control and Prevention, Atlanta, GA 30333
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Abstract

Objective:

To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.

Design:

To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point-prevalence survey was repeated 2 months after the cohort ward was established.

Results:

Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients, P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients, P=.002); and observed staff-patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions, P<.0001).

Conclusions:

Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 2 , February 1999 , pp. 106 - 109
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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