In addition, CP are expensive and associated with increased rates of patient adverse events. Hospitalists can lead the effort to ensure optimal hand hygiene and work with local infection control teams to reevaluate the utility of CP for patients with MRSA and VRE.
Do you think this is a low-value practice? Skip to main content. J Hosp Infect. Intervention to reduce transmission of resistant bacteria in intensive care. N Engl J Med. Abstract MDRO. Ray et al. However, comparing these results to those presented here is difficult, given the stark differences between patient groups.
The study by Ray et al. We believe that ICU patients co-colonized with VRE and MRSA are at risk of acquiring and transmitting VRSA because they generally are exposed to greater antimicrobial selective pressure, have extended lengths of stay, greater likelihood of indwelling devices, greater severity of illness, and are more likely to have a history of previous hospitalization and related exposures than patients admitted to general medical wards.
Despite these differences, perirectal colonization of both organisms was similar between the patients in the study by Ray et al. A limitation of this study is that investigators were unable to determine the species of the VRE isolates. Historically, Enterococcus faecalis has been more likely to be associated with conjugation events and subsequent VRSA colonization or infection compared with E. Still, these data would have been useful and informative.
In summary, these data describe a high prevalence of patients co-colonized with VRE and MRSA on admission to an ICU at a tertiary-care hospital, none of whom would have been detected by clinical culture. Given that many of these patients were discharged to other institutions, treating physicians and infection control personnel must be cognizant of the risks for VRSA colonization and infection and use appropriate precautions.
Funding organizations provided salary support only for stated investigators. His primary research interests include antimicrobial resistance, foodborne disease, and epidemiologic methodology. Methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization. Emerg Infect Dis [serial on the Internet].
National Center for Biotechnology Information , U. Journal List Emerg Infect Dis v. Emerg Infect Dis. Jon P. Eli N. Judith A.
Jessina C. Glenn Morris, Jr. Sandra M. Lucia L. Harold C. Joan N. Anthony D. Nosocomial Infections are hospital-associated or healthcare-associated infections. The Center for Disease Control and Prevention estimates that each year nearly 2 million patients in the United States contract infections in hospitals and about 90, of these patients die as a result of their infection. Staphylococcal bacteria or staph can cause serious infections, such as surgical wound infections, blood stream infections and pneumonia.
Once medically ready to be discharged, the patient may go home to a nursing homeor rehabilitation center. Prior to discharge of a VRE patient to another institution,hospital staff should inform personnel at the receiving facility that the patient iscolonized by VRE. Most facilities have programs to control VRE in their unique setting. Patients infected or colonized with this organism are placed inisolation and treated with vancomycin as needed.
Unlike enterococci, Staphylococcus aureus is a highly pathogenicbacterium, which is moderately contagious and causes infections such as endocarditis,bacteremia, surgical site infections, intra-abdominal abscesses, and pneumonia. It will bea public health nightmare if MRSA develop resistance to vancomycin. VRE is a bacterium that is becoming more prevalent in patient populations.
Patients intransplant units, oncology units, and intensive care units are at a higher risk ofacquiring VRE due to prolonged length of stay and treatment with multiple antibiotics. They are also frequently subjected to invasive procedures that place them at risk forcolonization with VRE. Healthcare workers in inpatient settings should care for VREpatients using barrier precautions, which includes use of gowns and gloves and handwashingbefore and after each patient contact.
It is essential that all equipment used on VREpatients be cleaned daily to decrease microbial load. Equipment that is no longer neededfor a VRE patient must be decontaminated prior to use on the next patient. Pamela S. Glen Mayhall, MD, for his overall guidance with thisarticle. July 1, By Pamela S. Risk Factors Most patients colonized by VRE have been in intensive care units, transplant units, andoncology units.
The infection control measures are as follows: Place VRE-infected or colonized patients in a single room or in the same room as another patient with VRE. Wear a clean non-sterile gown when entering the room of a VRE infected or colonized patient if substantial contact with the patient or environmental surfaces in the patient's room is anticipated or if the patient is incontinent, or has diarrhea, an ileostomy, a colostomy, or wound drainage not contained by a dressing. Wear clean non-sterile gloves when entering the room of a VRE-infected or colonized patient.
During the course of caring for the patient, a change of gloves may be necessary after contact with materials that may contain high concentrations of VRE i.
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