Disinfection of Hospital Rooms Contaminated with Vancomycin-Resistant Enterococcus faecium

Byers, Karin E.; Durbin, Lisa J.; Simonton, Barbara M.; Anglim, Anne M.; Adal, Karim A.; Farr, Barry M.

doi:10.2307/30142418

Cited by 56 publications

(51 citation statements)

References 12 publications

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“…In addition, VRE contamination has been shown to persist through 3 standard room cleanings, even with bucket-based cloth-immersion cleaning. 7 Study limitations include the lack of data regarding antibiotic use. Antibiotic exposure is associated with increased VRE shedding among carriers and increased VRE acquisition among patients exposed to carriers.…”

Section: Commentmentioning

confidence: 99%

Environmental Cleaning Intervention and Risk of Acquiring Multidrug-Resistant Organisms From Prior Room Occupants

Datta¹,

Platt²,

Yokoe³

et al. 2011

Arch Intern Med

189

129

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Section: Commentmentioning

confidence: 99%

Environmental Cleaning Intervention and Risk of Acquiring Multidrug-Resistant Organisms From Prior Room Occupants

Datta¹,

Platt²,

Yokoe³

et al. 2011

Arch Intern Med

189

129

View full text Add to dashboard Cite

“…Routinely used disinfectants such as quaternary ammonium, phenolic, and iodophor germicidals are active against VRE (224). However, several studies have shown improved rates of VRE surface eradication with enhanced disinfection involving a more thorough application of the disinfectant to the surface by drenching either the surface or the cleaning rag (42,305).…”

Section: Vancomycin-resistant Enterococcusmentioning

confidence: 99%

Hospital Epidemiology and Infection Control in Acute-Care Settings

2011

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SUMMARY Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.

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“…Environmental sampling studies have isolated VRE from most surfaces found in rooms that previously housed infected patients, such as patient gowns, bedside rails, floors, doorknobs, and blood pressure cuffs (12). Enterococcus has been shown to persist for as long as 4 months on surfaces, and in a clinical setting, VRE was shown to persist through an average of 2.8 standard room cleanings, thereby acting as a continual source for possible transmission (40,41). Recent studies involving environmental surveillance suggest that admission to a room previously occupied by a patient with VRE infection was associated with a significant increased risk for VRE acquisition by subsequent patients (hazard ratio, 4.4) (42).…”

Section: Enterococcus Spp In the Health Care Settingmentioning

confidence: 99%

Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting

2016

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bInfections attributable to vancomycin-resistant Enterococcus (VRE) strains have become increasingly prevalent over the past decade. Prompt identification of colonized patients combined with effective multifaceted infection control practices can reduce the transmission of VRE and aid in the prevention of hospital-acquired infections (HAIs). Increasingly, the clinical microbiology laboratory is being asked to support infection control efforts through the early identification of potential patient or environmental reservoirs. This review discusses the factors that contribute to the rise of VRE as an important health care-associated pathogen, the utility of laboratory screening and various infection control strategies, and the available laboratory methods to identify VRE in clinical specimens. Hospital-acquired infections (HAIs) are a serious threat for patient care and carry a significant cost to hospitals, since treatment of these infections is no longer reimbursable. In addition, regulations requiring hospitals to report HAIs creates further pressure to reduce incidence rates. Screening patients at admission for methicillin-resistant Staphylococcus aureus (MRSA) has been a successful approach in reducing MRSA HAIs in some health care systems and may be a successful strategy for controlling other health care-associated pathogens, including Clostridium difficile, carbapenem-resistant Enterobacteriaceae (CRE), and vancomycin-resistant Enterococcus (VRE) (1). However, there is debate about the optimal approach to screening and infection control, which may differ between pathogens of interest.Members of the genus Enterococcus are well-documented pathogens associated with various clinical manifestations, including bacteremia, infective endocarditis, intra-abdominal and pelvic infections, urinary tract infections, and, in rare cases, central nervous system infections (2-4). Infection with vancomycin-resistant Enterococcus is associated with an increased mortality rate, illustrated by a 2.5-fold increase in mortality for patients suffering from VRE bacteremia (5). Vancomycin resistance in Enterococcus spp. has been increasing in prevalence since it was first encountered in 1986 (6, 7). Currently, 30% of Enterococcus species isolates from the United States are vancomycin resistant, and infection with these organisms causes an estimated 1,300 deaths each year (8). The majority of VRE are associated with the species E. faecium (77%) and E. faecalis (9%), with the remaining 14% of isolates representing species less frequently implicated in serious infections, including E. gallinarum, E. casseliflavus, E. avium, and E. raffinosus (8).The optimal approach to reducing VRE infections is multifactorial, requiring antimicrobial stewardship to reduce the selection of VRE in colonized patients, appropriate infection control practices to reduce transmission, and reliable sensitive laboratory methods for the detection of VRE in a timely manner. ANTIMICROBIAL RESISTANCE MECHANISMS AND APPROACHES TO THERAPYUnderstanding the mechanism be...

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Disinfection of Hospital Rooms Contaminated with Vancomycin-Resistant Enterococcus faecium

Cited by 56 publications

References 12 publications

Environmental Cleaning Intervention and Risk of Acquiring Multidrug-Resistant Organisms From Prior Room Occupants

Environmental Cleaning Intervention and Risk of Acquiring Multidrug-Resistant Organisms From Prior Room Occupants

Hospital Epidemiology and Infection Control in Acute-Care Settings

Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting

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