Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-30T20:22:58.383Z Has data issue: false hasContentIssue false

Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

Published online by Cambridge University Press:  02 January 2015

Mandy Bodily*
Affiliation:
Barnes-Jewish Hospital, Infection Prevention Department, Saint Louis, Missouri
Kathleen M. McMullen
Affiliation:
Barnes-Jewish Hospital, Infection Prevention Department, Saint Louis, Missouri
Anthony J. Russo
Affiliation:
Barnes-Jewish Hospital, Infection Prevention Department, Saint Louis, Missouri
Nupur D. Kittur
Affiliation:
Washington University in Saint Louis, Infectious Diseases, Saint Louis, Missouri
Joan Hoppe-Bauer
Affiliation:
Barnes-Jewish Hospital, Microbiology Laboratory, Saint Louis, Missouri
David K. Warren
Affiliation:
Washington University in Saint Louis, Infectious Diseases, Saint Louis, Missouri
*
8451 Pearl Street, Denver, CO 80229 ([email protected])

Abstract

Discontinuation of reflex testing of stool submitted for Clostridium difficile testing for vancomycin-resistant enterococci (VRE) led to an increase in the number of patients with healthcare-associated VRE bacteremia and bacteriuria (0.21 vs 0.36 cases per 1,000 patient-days; P < .01). Cost-benefit analysis showed reflex screening and isolation of VRE reduced hospital costs.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Butler, A, Olsen, M, Merz, L, Guth, R, Woeltje, K, Camins, B, Fraser, V. Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort. Infect Control Hosp Epidemiol 2010;31(1):2835.Google Scholar
2.Garbutt, J, Littenberg, B, Evanoff, B, Sahm, D, Mundy, L. Enteric carriage of vancomycin-resistant Enterococcusfaecium in patients tested for Clostridium difficile. Infect Control Hosp Epidemiol 1999;20(10):664670.Google Scholar
3.Ray, A, Hoyen, C, Das, S, Eckstein, E, Donskey, C. Undetected vancomycin-resistant enterococcus stool colonization in a Veterans Affairs hospital using a Clostridium difficile-focused surveillance strategy. Infect Control Hosp Epidemiol 2002;23(8):474477.Google Scholar
4.Burger, T, Fry, D, Fusco, R, et al.Multihospitals surveillance of nosocomial methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile, analysis of a 4-year data sharing project, 1999-2002. Am J Infect Control 2006;34(7):458454.Google Scholar
5.Sheetz, M, Knechtel, SA, Malczynski, M, Postelnick, MJ, Qi, C. Increasing incidence of linezolid-intermediate or -resistant, vancomycin-resistant Enterococcus faecium strains parallels increasing linezolid consumption. Antimicrob Agents Chemother 2008; 52(6):22562259.Google Scholar
6.Ajao, A, Harris, A, Roghman, M, et al.Systematic review of measurement and adjustment for colonization pressure in studies of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, and Clostridium difficile acquisition. Infect Control Hosp Epidemiol 2011;32(5):481489.Google Scholar
7.Wagner, A, Soumerai, S, Zhang, F, Ross-Dengan, D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther 2002:27(4):299309.Google Scholar
8.Muto, C, Jernigan, J, Ostrowsky, B, et al.SHEA guideline for preventing nosocomial transmission of multi-drug resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol 2003;24(5):362386.Google Scholar
9.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. Management of multi drug-resistant organisms in healthcare settings, 2006. Am J Infect Control 2007;35(10)(suppl):S65S194.Google Scholar
10.Calfee, D, Gianetta, E, Durbin, L, Germanson, T, Farr, B. Control of endemic vancomycin-resistant Enterococcus among inpatients at a university hospital. Clin Infect Dis 2003:37(3):326332.Google Scholar
11.Lucet, JC, Armand-Lefevre, L, Laurichesse, JJ, et al.Rapid control of an outbreak of vancomycin-resistance Enterococci in a French university hospital. J Hosp Infect 2007;67(1):4248.Google Scholar