Article Figures & Tables
Figures
- Figure 1
Flow diagram of blood cultures positive for vancomycin-resistant Enterococcus (VRE) occurring between January 2009 and June 2015 in Ontario.
- Figure 2
Numbers of cases and rates per 100 000 patient-days of blood cultures positive for vancomycin-resistant Enterococcus, January 2009-June 2015.
- Figure 3
Rates of blood cultures positive for vancomycin-resistant Enterococcus (VRE), January 2009-June 2015, stratified by hospitals that ceased VRE screening and isolation practices within the study period versus hospitals that continued screening and isolation practices within the study period.
- Figure 4
Rates of blood cultures positive for vancomycin-resistant Enterococcus (VRE) in acute teaching hospitals, January 2009-June 2015, stratified by hospitals that ceased VRE screening and isolation practices within the study period (n = 9) versus hospitals that continued screening and isolation practices within the study period (n = 10).
Tables
- Table 1: Incidence rate of VRE-positive blood cultures per 100 000 patient-days in Ontario between January 2009 and June 2015, overall and by whether VRE screening and isolation practices were ceased or continued
Variable Incidence rate per 100 000 patient-days Total
n = 395Screening ceased
n = 194Screening continued
n = 201Hospital type Acute teaching 1.74 2.50 1.11 Large community 0.47 0.41 0.48 Small community 1.81 0.88 2.13 Case attribution Reporting facility 0.81 1.70 0.54 Other facility 0.07 0.07 0.06 Unknown 0.16 0.36 0.09 Year 2009 0.94 2.54 0.43 2010 0.55 1.38 0.30 2011 0.82 1.67 0.56 2012 1.13 1.75 0.94 2013 1.21 2.74 0.74 2014 1.36 2.48 1.00 2015 1.37 2.60 0.97 Note: VRE = vancomycin-resistant Enterococcus.
- Table 2: Annual change in the incidence rate (slope*) of VRE-positive blood cultures before, after and slope change† after versus before discontinuation of VRE screening and isolation (in ceased-screening cohort) and June 2012 (in screening cohort) in unadjusted and adjusted analysis and sensitivity analyses restricting analyses to 1) acute teaching hospitals, 2) cases attributable to the reporting facility and 3) lagged-effect models incorporating a 3-month lag and 6-month lag
Variable Unadjusted incidence rate ratio Slope change
p valueAdjusted incidence rate ratio Slope change
p valueSlope before Slope after Slope change
(95% CI)Slope before Slope after Slope change
(95% CI)Main analysis (n = 395 cases) Ceased-screening cohort No lag 0.80 1.09 1.37 (1.04-1.80) 0.03 0.90 1.12 1.25 (1.01-1.54) 0.04 3-mo lag 0.80 1.20 1.51 (1.14-2.00) 0.004 0.90 1.24 1.38 (1.07-1.79) 0.01 6-mo lag 0.80 1.35 1.70 (1.27-2.27) 0.0004 0.90 1.39 1.56 (1.19-2.03) 0.001 Screening cohort No lag 1.32 1.06 0.80 (0.59-1.09) 0.2 1.31 1.06 0.81 (0.56-1.15) 0.2 3-mo lag 1.32 1.23 0.93 (0.68-1.28) 0.7 1.31 1.23 0.94 (0.66-1.33) 0.7 6-mo lag 1.32 1.52 1.15 (0.83-1.60) 0.4 1.31 1.52 1.16 (0.81-1.66) 0.4 Acute teaching hospitals (n = 287 cases) Ceased-screening cohort No lag 0.84 1.12 1.34 (0.99-1.83) 0.06 0.84 1.13 1.35 (1.13-1.60) < 0.01 3-mo lag 0.84 1.25 1.49 (1.09-2.05) 0.01 0.84 1.25 1.49 (1.19-1.88) < 0.01 6-mo lag 0.84 1.41 1.68 (1.22-2.32) 0.002 0.84 1.41 1.68 (1.32-2.14) < 0.001 Screening cohort No lag 1.23 0.88 0.72 (0.46-1.13) 0.2 1.23 0.88 0.72 (0.45-1.15) 0.2 3-mo lag 1.23 1.01 0.82 (0.52-1.30) 0.4 1.23 1.01 0.82 (0.53-1.27) 0.4 6-mo lag 1.23 1.40 1.13 (0.70-1.83) 0.6 1.23 1.40 1.13 (0.98-1.88) 0.6 Cases attributable to reporting facility (n = 309 cases) Ceased-screening cohort No lag 0.86 1.16 1.35 (0.99-1.85) 0.06 0.93 1.18 1.27 (0.95-1.70) 0.1 3-mo lag 0.86 1.30 1.51 (1.09-2.08) 0.01 0.93 1.32 1.42 (0.96-2.10) 0.08 6-mo lag 0.86 1.40 1.62 (1.17-2.26) 0.004 0.93 1.42 1.53 (1.05-2.23) 0.03 Screening cohort No lag 1.47 1.00 0.68 (0.48-0.97) 0.03 1.46 1.00 0.69 (0.48-0.98) 0.04 3-mo lag 1.47 1.14 0.77 (0.54-1.11) 0.2 1.46 1.14 0.78 (0.55-1.11) 0.2 6-mo lag 1.47 1.41 0.96 (0.66-1.39) 0.8 1.46 1.41 0.96 (0.67-1.39) 0.8 Note: CI = confidence interval, VRE = vancomycin-resistant Enterococcus.
*Defined as the year-over-year ratio change in incidence. For example, a slope of 1.1 would represent a 10% multiplicative growth in the incidence rate per year, and a slope of 0.9 would represent a 10% reduction in incidence per year.
†Defined as the ratio of the slope after the cessation of screening divided by the slope before the cessation of screening in the ceased-screening cohort (and after June 2012 v. before June 2012 in the screening cohort).
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