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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

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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