Controlling the spread of vancomycin-resistant enterococci. Is active screening worthwhile?

Humphreys, Hilary

doi:10.1016/j.jhin.2014.09.002

Cited by 65 publications

(48 citation statements)

References 57 publications

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“…[14] Active screening outside outbreak settings can be a costly exercise and especially difficult in resourceconstrained health systems. Screening in children has revealed low rates of colonisation.…”

Section: Discussionmentioning

confidence: 99%

Emergence of vancomycin-resistant Enterococcus at a tertiary paediatric hospital in South Africa

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Emergence of vancomycin-resistant Enterococcus at a tertiary paediatric hospital in South Africa

et al. 2016

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“…Asimismo, estudios desarrollados durante la última década han demostrado que el control de la colonización por el ERV sigue siendo una de las principales medidas para prevenir las infecciones causadas por esta bacteria. Por tal motivo, diversos investigadores a nivel mundial, han desarrollado estudios para determinar la frecuencia de colonización por el ERV dentro de los ambientes hospitalarios (3) . …”

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Colonización por enterococo resistente a vancomicina en pacientes internados de un hospital de Lima, Perú

Estrada-Roman

Mendo-Lopez

Astocondor

et al. 2017

Rev Peru Med Exp Salud Publica

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Con el objetivo de determinar la frecuencia de colonización por el enterococo resistente a vancomicina (ERV), el genotipo de resistencia y los factores asociados, se realizó un estudio de tipo transversal durante noviembre y diciembre del 2013 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró una frecuencia de colonización por ERV de 6,2% (IC 95%: 1,67-10,73), todas las cepas aisladas tenían el genotipo de resistencia vanA, y se halló que las variables hospitalización previa (p=0,001) y el uso de cefalosporinas de tercera generación (p=0,016) estaban asociadas a la colonización por ERV. En conclusión, existe colonización perianal por ERV en los diversos servicios de hospitalización, el gen vanA podría ser transmitido a gérmenes más virulentos y ocasionar la aparición de la bacteria Staphylococcus aureus resistente a vancomicina (VRSA). Es necesario adoptar medidas de control de infecciones para evitar la transmisión de esta bacteria en el ambiente hospitalario. Palabras clave: Enterococcus, resistencia a la vancomicina, pacientes internos. (Fuente: DeCS BIREME) COLONIZATION BY ENTEROCOCCAL STRAINS RESISTANT TO VANCOMYCIN IN PATIENTS FROM A HOSPITAL IN LIMA, PERU ABSTRACTThis cross-sectional study was conducted from November to December of 2013 at the Cayetano Heredia National Hospital in Lima, Peru, to determine the rate of infection with vancomycin-resistant enterococcus (VRE), the resistance genotype, and associated factors. The rate of infection with VRE was 6.2% (95% confidence interval [CI]: 1.67-10.73) and the resistance genotype isolated from all strains was the vanA gene. The factors associated with colonization with VRE were previous hospitalizations (p = 0.001) and the use of third-generation cephalosporins (p = 0.016). In conclusion, perianal colonization with VRE is present in many hospital services. Moreover, the vanA gene may cause resistance to vancomycin and promote the development of vancomycin-resistant Staphylococcus aureus. Therefore, infection control measures should be adopted to prevent the dissemination of this bacterial strain in hospital settings. Key words: Enterococcus, vancomycin resistance, inpatient. (Source: MeSH NLM). INTRODUCCIÓNDesde su emergencia en los Estados Unidos, las infecciones causadas por la bacteria enterococo resistente a vancomicina (ERV) han generado gran preocupación en la comunidad médica (1) . La resistencia intrínseca de la bacteria a los aminoglucósidos, y la adquirida a los glicopéptidos, limitan las opciones terapéuticas de las infecciones causadas por esta bacteria. Asimismo, sus múltiples vías de transmisión dentro de los ambientes hospitalarios, su capacidad de colonizar la región perianal hasta por un año y su potencialidad de transmitir el gen de resistencia a la vancomicina a otras especies más virulentas como el Staphylococcus aureus, hacen que el ERV sea por estos días un problema de salud pública (1,2) . Asimismo, estudios desarrollados durante la última década han demostrado que el control de la colonización por el ERV sigue sien...

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“…Scientific evidence on how to handle VRE is still low, and it is suggested that management should be done according to "local needs and resources" (13). On the other hand, active surveillance for at-risk populations in hospital settings has been suggested (4,14), and surveillance programs are thought to be an important cornerstone in the prevention of infections with VRE. Active screening may help in preventing VRE infections (recently reviewed in reference 14).…”

mentioning

confidence: 99%

“…On the other hand, active surveillance for at-risk populations in hospital settings has been suggested (4,14), and surveillance programs are thought to be an important cornerstone in the prevention of infections with VRE. Active screening may help in preventing VRE infections (recently reviewed in reference 14). Screening is recommended for patients on critical care units and transplant and hematology wards as well as patients undergoing chronic dialysis (14).…”

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Development of a Real-Time PCR Protocol Requiring Minimal Handling for Detection of Vancomycin-Resistant Enterococci with the Fully Automated BD Max System

2016

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. We evaluated two protocols: one using a liquid master mix and the other employing commercially ordered dry-down reagents. The BD Max VRE PCR was evaluated in two rounds with 86 and 61 rectal elution swab (eSwab) samples, and the results were compared to the culture results. The sensitivities of the different PCR formats were 84 to 100% for vanA and 83.7 to 100% for vanB; specificities were 96.8 to 100% for vanA and 81.8 to 97% for vanB. The use of dry-down reagents and the ExK DNA-2 kit for extraction showed that the samples were less inhibited (3.3%) than they were by the use of the liquid master mix (14.8%). Adoption of a cutoff threshold cycle of 35 for discrimination of vanB-positive samples allowed an increase of specificity to 87.9%. The performance of the BD Max VRE assay equaled that of the BD GeneOhm VanR assay, which was run in parallel. The use of dry-down reagents simplifies the assay and omits any need to handle liquid PCR reagents.

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Controlling the spread of vancomycin-resistant enterococci. Is active screening worthwhile?

Cited by 65 publications

References 57 publications

Emergence of vancomycin-resistant Enterococcus at a tertiary paediatric hospital in South Africa

Emergence of vancomycin-resistant Enterococcus at a tertiary paediatric hospital in South Africa

Colonización por enterococo resistente a vancomicina en pacientes internados de un hospital de Lima, Perú

Development of a Real-Time PCR Protocol Requiring Minimal Handling for Detection of Vancomycin-Resistant Enterococci with the Fully Automated BD Max System

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