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RESEARCH ARTICLE
Contents Vol 35(1)

Vancomycin-resistant enterococci in hospitals

John Ferguson
+ Author Affiliations
- Author Affiliations

Hunter New England Health
Tel: +61 2 4921 4444
Email: john.ferguson@hnehealth.nsw.gov.au

Microbiology Australia 35(1) 38-43 https://doi.org/10.1071/MA14011
Published: 13 February 2014

Abstract

Control measures for vancomycin-resistant enterococci (VRE) should be determined by the current epidemiology of infection and must be practical and effective. It is essential that emphasis is placed on consistent implementation of enhanced standard precautions (horizontal measures) in healthcare that reduce infections caused by all organisms, not just VRE. Effective antimicrobial stewardship programs are paramount and should target reduction in the use of extended-spectrum cephalosporins, carbapenems and fluoroquinolones. VRE causes marked morbidity in a limited range of at-risk patient groups who require additional active measures to prevent their acquisition of virulent strains. The use of additional measures for patients at low risk from VRE morbidity is unlikely to be cost-effective and should be reserved for outbreak situations or for patients who are more likely to transmit VRE.


References

[1]  Harbarth, S. and Uckay, I. (2004) Are there patients with peritonitis who require empiric therapy for enterococcus? Eur. J. Clin. Microbiol. Infect. Dis. 23, 73–77.
| Are there patients with peritonitis who require empiric therapy for enterococcus?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c7gtVemsg%3D%3D&md5=029cc0057ac685683684738dae9c9811CAS | 14735401PubMed |

[2]  Khair, H.N. et al. (2013) Vancomycin resistance has no influence on outcomes of enterococcal bacteriuria. J. Hosp. Infect. 85, 183–188.
| Vancomycin resistance has no influence on outcomes of enterococcal bacteriuria.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3sbkslSisw%3D%3D&md5=7dbec9d830b6968538d0b50a9dee5b5aCAS | 23998947PubMed |

[3]  Orsi, G.B. and Ciorba, V. (2013) Vancomycin resistant enterococci healthcare associated infections. Ann. Ig. 25, 485–492.
| 1:STN:280:DC%2BC2c3it1ejsg%3D%3D&md5=6b400ee62a10c3e26c4a297367b7f325CAS | 24284534PubMed |

[4]  Leclercq, R. et al. (1988) Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N. Engl. J. Med. 319, 157–161.
| Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1c3mtFCmug%3D%3D&md5=53592b20d28cd75b12be7d081e1a56cbCAS | 2968517PubMed |

[5]  Willems, R.J. et al. (2005) Global spread of vancomycin-resistant Enterococcus faecium from distinct nosocomial genetic complex. Emerg. Infect. Dis. 11, 821–828.
| Global spread of vancomycin-resistant Enterococcus faecium from distinct nosocomial genetic complex.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXlsFSit7s%3D&md5=d0c4013135272880c913ad9e436f226cCAS | 15963275PubMed |

[6]  Johnson, P.D. et al. (2010) A sustained hospital outbreak of vancomycin-resistant Enterococcus faecium bacteremia due to emergence of vanB E. faecium sequence type 203. J. Infect. Dis. 202, 1278–1286.
| A sustained hospital outbreak of vancomycin-resistant Enterococcus faecium bacteremia due to emergence of vanB E. faecium sequence type 203.Crossref | GoogleScholarGoogle Scholar | 20812846PubMed |

[7]  Christiansen, K. et al. (2010) 2010 antimicrobial susceptibility and VRE characterisation report. http://www.agargroup.org/files/ENTE%202010%20Report%20Final%20secure.pdf (accessed 14 January 2014).

[8]  Coombs, G.W. et al. (2014) A change in the molecular epidemiology of vancomycin resistant enterococci in Western Australia. Pathology 46, 73–75.
| A change in the molecular epidemiology of vancomycin resistant enterococci in Western Australia.Crossref | GoogleScholarGoogle Scholar | 24300724PubMed |

[9]  Howden, B.P. et al. (2013) Genomic insights to control the emergence of vancomycin-resistant enterococci. MBio, 4, .
| 1:CAS:528:DC%2BC3sXhsFSqtr7F&md5=26d4b1085945b1d4f59e6e348aa95602CAS |

[10]  Graham, M. et al. (2008) High rates of fecal carriage of nonenterococcal vanB in both children and adults. Antimicrob. Agents Chemother. 52, 1195–1197.
| High rates of fecal carriage of nonenterococcal vanB in both children and adults.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXivFaltbg%3D&md5=6d6b5705c8189be1da7bfa43cec2eefeCAS | 18180361PubMed |

[11]  Christiansen, K.J. et al. (2004) Eradication of a large outbreak of a single strain of vanB vancomycin-resistant Enterococcus faecium at a major Australian teaching hospital. Infect. Control Hosp. Epidemiol. 25, 384–390.
| Eradication of a large outbreak of a single strain of vanB vancomycin-resistant Enterococcus faecium at a major Australian teaching hospital.Crossref | GoogleScholarGoogle Scholar | 15188843PubMed |

[12]  Padiglione, A.A. et al. (2001) The prevalence of fecal colonization with VRE among residents of long-term-care facilities in Melbourne, Australia. Infect. Control Hosp. Epidemiol. 22, 576–578.
| The prevalence of fecal colonization with VRE among residents of long-term-care facilities in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mnos1ensg%3D%3D&md5=217c9946b5e6b09407bb4fc7a93046daCAS | 11732788PubMed |

[13]  McBride, S.J. et al. (2010) Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia: a five-year retrospective review. Eur. J. Clin. Microbiol. Infect. Dis. 29, 107–114.
| Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia: a five-year retrospective review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXjt1ygsw%3D%3D&md5=3abbd056000e0d5404f15a458a7d7e0aCAS | 19916034PubMed |

[14]  Institute of Environmental Science and Research, New Zealand. (2012) Vancomycin-resistant enterococci, 2012. https://surv.esr.cri.nz/PDF_surveillance/Antimicrobial/VRE/VRE_2012.pdf (accessed 31 January 2014).

[15]  Bartley, P.B. et al. (2001) The relationship of a clonal outbreak of Enterococcus faecium vanA to methicillin-resistant Staphylococcus aureus incidence in an Australian hospital. J. Hosp. Infect. 48, 43–54.
| The relationship of a clonal outbreak of Enterococcus faecium vanA to methicillin-resistant Staphylococcus aureus incidence in an Australian hospital.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3msl2msA%3D%3D&md5=9dd234a1e6e9576c97c6e20a36baa0baCAS | 11358470PubMed |

[16]  Mutters, N.T. et al. (2013) Control of the spread of vancomycin-resistant Enterococci in hospitals: epidemiology and clinical relevance. Dtsch. Arztebl. Int. 110, 725–731.
| 24222791PubMed |

[17]  Boyce, J.M. (2007) Environmental contamination makes an important contribution to hospital infection. J. Hosp. Infect. 65, 50–54.
| Environmental contamination makes an important contribution to hospital infection.Crossref | GoogleScholarGoogle Scholar | 17540242PubMed |

[18]  Friedman, N.D. et al. (2013) The effectiveness of a single-stage versus traditional three-staged protocol of hospital disinfection at eradicating vancomycin-resistant Enterococci from frequently touched surfaces. Am. J. Infect. Control 41, 227–231.
| The effectiveness of a single-stage versus traditional three-staged protocol of hospital disinfection at eradicating vancomycin-resistant Enterococci from frequently touched surfaces.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXktlOitLs%3D&md5=a5a1bf7b37495ec228d870a98d280efeCAS | 22981721PubMed |

[19]  Vickery, K. et al. (2012) Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit. J. Hosp. Infect. 80, 52–55.
| Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38%2FpslahtA%3D%3D&md5=3849e2ffa016a96ceb53a0aab6d5ba20CAS | 21899921PubMed |

[20]  Lee, B.Y. et al. (2013) Modeling the regional spread and control of vancomycin-resistant enterococci. Am. J. Infect. Control 41, 668–673.
| Modeling the regional spread and control of vancomycin-resistant enterococci.Crossref | GoogleScholarGoogle Scholar | 23896284PubMed |

[21]  McBryde, E.S. et al. (2007) Characterizing an outbreak of vancomycin-resistant enterococci using hidden Markov models. J. R. Soc. Interface 4, 745–754.
| Characterizing an outbreak of vancomycin-resistant enterococci using hidden Markov models.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2szoslektw%3D%3D&md5=66889a5b7f789f88359bb15ea7cbdc75CAS | 17360254PubMed |

[22]  Karki, S. et al. (2013) Long-term carriage of vancomycin-resistant enterococci in patients discharged from hospitals: a 12-year retrospective cohort study. J. Clin. Microbiol. 51, 3374–3379.
| Long-term carriage of vancomycin-resistant enterococci in patients discharged from hospitals: a 12-year retrospective cohort study.Crossref | GoogleScholarGoogle Scholar | 23926167PubMed |

[23]  Quale, J. et al. (1996) Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci. Clin. Infect. Dis. 23, 1020–1025.
| Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s%2FotFGmsQ%3D%3D&md5=793fd5e1ae3ce63b740b58b8db075c7dCAS | 8922796PubMed |

[24]  Paterson, D.L. et al. (2008) Acquisition of rectal colonization by vancomycin-resistant Enterococcus among intensive care unit patients treated with piperacillin-tazobactam versus those receiving cefepime-containing antibiotic regimens. Antimicrob. Agents Chemother. 52, 465–469.
| Acquisition of rectal colonization by vancomycin-resistant Enterococcus among intensive care unit patients treated with piperacillin-tazobactam versus those receiving cefepime-containing antibiotic regimens.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXhtlSqur4%3D&md5=b0eab0b16c6ec734d65514889c5c9c54CAS | 18025111PubMed |

[25]  Harris, A.D. et al. (2001) Methodological principles of case-control studies that analyzed risk factors for antibiotic resistance: a systematic review. Clin. Infect. Dis. 32, 1055–1061.
| Methodological principles of case-control studies that analyzed risk factors for antibiotic resistance: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3MXjsVWgsbg%3D&md5=081e8fbb928ddab2ef76f855e53b198dCAS | 11264034PubMed |

[26]  McKinnell, J.A. et al. (2012) Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage. Infect. Control Hosp. Epidemiol. 33, 718–724.
| Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage.Crossref | GoogleScholarGoogle Scholar | 22669234PubMed |

[27]  Chavers, L.S. et al. (2003) Association between antecedent intravenous antimicrobial exposure and isolation of vancomycin-resistant enterococci. Microb. Drug Resist. 9, S69–S77.
| Association between antecedent intravenous antimicrobial exposure and isolation of vancomycin-resistant enterococci.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXhtVSqsrzJ&md5=921f5128aa328f36207a6ce29364f487CAS | 14633370PubMed |

[28]  Karki, S. et al. (2012) Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study. Antimicrob Resist Infect Control 1, 31.
| Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study.Crossref | GoogleScholarGoogle Scholar | 23039285PubMed |

[29]  Bonten, M.J. et al. (1998) The role of ‘colonization pressure’ in the spread of vancomycin-resistant enterococci: an important infection control variable. Arch. Intern. Med. 158, 1127–1132.
| The role of ‘colonization pressure’ in the spread of vancomycin-resistant enterococci: an important infection control variable.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3ms1yhsA%3D%3D&md5=f2672400ae1eebd4f59e5c7d5337df77CAS | 9605785PubMed |

[30]  Dancer, S.J. et al. (2013) Approaching zero: temporal effects of a restrictive antibiotic policy on hospital-acquired Clostridium difficile, extended-spectrum beta-lactamase-producing coliforms and meticillin-resistant Staphylococcus aureus. Int. J. Antimicrob. Agents 41, 137–142.
| Approaching zero: temporal effects of a restrictive antibiotic policy on hospital-acquired Clostridium difficile, extended-spectrum beta-lactamase-producing coliforms and meticillin-resistant Staphylococcus aureus.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXotVWj&md5=4aa65790fec498a4028329d3f5053ca3CAS | 23276500PubMed |

[31]  Australian Commission on Safety and Quality in Healthcare (2012) Australian Health service safety and quality accreditation scheme. http://www.safetyandquality.gov.au/our-work/accreditation/ahssqa-scheme/ (accessed 14 January 2014).

[32]  Australasian Health Facility Guidelines (AusHFG) (2013) Part D: infection prevention and control. http://www.healthfacilityguidelines.com.au/default.aspx (accessed 13 January 2014).

[33]  Passaretti, C.L. et al. (2013) An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms. Clin. Infect. Dis. 56, 27–35.
| An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhvVCksL7K&md5=adc35ba94b7eb91a948808a14cd600ddCAS | 23042972PubMed |

[34]  Siegel, J.D. et al. (2007) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am. J. Infect. Control 35, S65–S164.
| 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.Crossref | GoogleScholarGoogle Scholar | 18068815PubMed |

[35]  NHMRC (2010) Australian Guidelines for the Prevention and Control of Infection in Healthcare. http://www.nhmrc.gov.au/book/html-australian-guidelines-prevention-and-control-infection-healthcare-2010 (accessed 14 January 2014).

[36]  Grabsch, E.A. et al. (2012) Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme. J. Hosp. Infect. 82, 234–242.
| Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3s%2FosF2ktg%3D%3D&md5=739200553bc39ed8ca1690c12afcb860CAS | 23103245PubMed |

[37]  Karki, S. and Cheng, A.C. (2012) Impact of non-rinse skin cleansing with chlorhexidine gluconate on prevention of healthcare-associated infections and colonization with multi-resistant organisms: a systematic review. J. Hosp. Infect. 82, 71–84.
| Impact of non-rinse skin cleansing with chlorhexidine gluconate on prevention of healthcare-associated infections and colonization with multi-resistant organisms: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38fnslShuw%3D%3D&md5=8127fbc1a716928247ec2ba17455cd80CAS | 22889522PubMed |