Rates of blood cultures positive for vancomycin-resistant Enterococcus in Ontario: a quasi-experimental study

Economic evaluation of vancomycin-resistant enterococci (VRE) control practices: a systematic review

“…However, it is likely that reductions in specific VRE control interventions could lead to an increase in VRE rates over time, but that the postdiscontinuation observation period (between 12 and 31 months) of a study was insufficient to detect this increase. A recent study in Ontario hospitals has shown that this effect can take several years [30]. Furthermore, two of these studies included the implementation of other interventions, such as chlorhexidine bathing [21], enhanced environmental cleaning [14] or antimicrobial stewardship programmes [14], which may further delay a rise in VRE rates.…”

Health care-associated infections in Canadian hospitals: still a major problem

“…conducted a 6year (2009-2015) cohort study of all Ontario acute care facilities to evalu ate the impact of this change in practice and found that in hospitals that changed their VRE control strategy, there was a sig nificant increase in the rate of rise of VRE bloodstream infections per year, whereas there was no change in rate in hospitals that con tinued screening. 7 Since the end of our study in 2015, rates of VRE bloodstream infection have doubled in Ontario, with the increase seen primarily at hospitals that discontinued VRE screening, while VRE bloodstream infection rates have remained stable at hospitals that continue to screen. 8 Despite being observational evidence, the temporal association of this observed rise with the change in the control strategy for VRE, and the stability of VRE bloodstream infec tion rates at hospitals that continue to screen, represent compel ling evidence to support continuation of VRE admission screening and use of contact precautions as a strategy to limit VRE transmis sion and prevent VRE infection.…”

“…Beginning in 2012, some hospitals discontinued their practice of admission screening and use of contact precautions for patients colonized and infected with VRE. 7 We (J.J. and G.G.) conducted a 6year (2009-2015) cohort study of all Ontario acute care facilities to evalu ate the impact of this change in practice and found that in hospitals that changed their VRE control strategy, there was a sig nificant increase in the rate of rise of VRE bloodstream infections per year, whereas there was no change in rate in hospitals that con tinued screening.…”

Investigating the relationship between vancomycin-resistant Enterococcus control practices and the incidence of health care–associated Clostridioides difficile infections in Ontario

“…Data on hospital VRE control programs were obtained from annual surveys performed by Public Health Ontario. 3…”