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Control of Endemic Glycopeptide-Resistant Enterococci

Published online by Cambridge University Press:  02 January 2015

Louise M. Dembry ,
Keke Uzokwe  and
Marcus J. Zervos
Louise M. Dembry
Affiliation:
Department of Internal Medicine, Detroit, Michigan Division of Infectious Diseases, Detroit, Michigan Wayne State University School of Medicine, Detroit, Michigan The Yale University School of Medicine, New Haven, Connecticut
Keke Uzokwe
Affiliation:
Department of Internal Medicine, Detroit, Michigan Division of Infectious Diseases, Detroit, Michigan The William Beaumont Hospital, Royal Oak, Michigan
Marcus J. Zervos
Affiliation:
Department of Internal Medicine, Detroit, Michigan Division of Infectious Diseases, Detroit, Michigan Wayne State University School of Medicine, Detroit, Michigan The William Beaumont Hospital, Royal Oak, Michigan
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Abstract

Objective: To evaluate the epidemiology of, and control measures for, vancomycin-resistant Enterococcus (VRE) in a renal unit.

Design: A 3-month, prospective, prevalence culture survey of patients on a 24-bed renal unit.

Setting: A 975-bed community teaching hospital.

Patients: Patients admitted to the renal unit over a 3-month period. Patients identified with VRE were each matched with four patients without VRE isolated over the study period.

Interventions/Control Measures: Resistant-organism barrier precautions. To eradicate carriage of VRE, two patients with VRE stool colonization were treated with 5 days of oral doxycycline (100 mg twice per day) and rifampin (300 mg/day).

Results: Seven patients with VRE (8 isolates) were identified. Five isolates were Enterococcus faecium (vancomycin MIC=16 to 256 μg/mL), two were Enterococcus faecalis (MICs=16 and 124 μg/mL), and one was Enterococcus gallinarum (MIC=8.0 μg/mL). Eradication of carriage with VRE was accomplished in two patients treated with doxycycline and rifampin. In the final 30 days of the culture survey and at 9 months, there were no further patients with VRE identified.

Conclusions: Resistant-organism precautions and elimination of patient carriage may be useful measures for controlling the spread of low-prevalence endemic vancomycin-resistant Enterococcus.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 5 , May 1996 , pp. 286 - 292
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

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