Brief reportThe risk of developing a vancomycin-resistant Enterococcus bloodstream infection for colonized patients
Section snippets
Epidemiology
Enterococcus is a resident normal flora of the gastrointestinal tract in which VRE colonization also occurs. Enterococci are intrinsically resistant to many antibiotics (including cephalosporins), and acquired resistance to penicillins, aminoglycosides, and glycopeptides is also a concern. VRE is now the second to third most common cause of nosocomial infections in US hospitals. Two species, Enterococcus faecalis and Enterococcus faecium, cause 90% of VRE infections in patients.4 The most
Risk factors
Risk factors for VRE colonization and infection include having an underlying comorbid condition such as diabetes; renal failure or malignancy; prolonged length of hospital stay, particularly with receipt of broad-spectrum antibiotics such as cephalosporins and vancomycin; having an indwelling invasive device or an invasive procedure; and close proximity to another VRE-colonized or -infected patient.8, 9, 10, 11, 12, 13
An association between VRE colonization and subsequent VRE BSI was reported
Infection control
Guidelines for the control of antibiotic-resistant organisms such as VRE include reducing emergence of the organism through antibiotic control or effective stewardship, reducing patient-to-patient spread by reducing contamination of the environment (disinfection, terminal cleaning, dedicated patient equipment), reducing contamination of the health care worker (hand hygiene; use of gowns, gloves, and masks), and reducing the reservoir for spread (Contact Precautions).23, 24 Our study suggests
Summary
VRE is an important cause of health care-acquired infections in US hospitals, and the incidence of VRE infections has been increasing in the past decade. Patients with VRE infections have increased length of illness and length of stay, increased costs of care, and increased mortality compared with those without VRE infections. VRE colonization is a precursor for developing VRE BSI, and the risk of VRE BSI among colonized patients varies dependent on the population studied. Risk factors for VRE
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Disclosures: Dr. Salgado received an honorarium for participating in the symposium and writing this article.