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Comparison of Three Methods to Recover Vancomycin-Resistant Enterococci (VRE) From Perianal and Environmental Samples Collected During A Hospital Outbreak of VRE

Published online by Cambridge University Press:  02 January 2015

Barbara S. Reisner ,
Stephanie Shaw ,
Mary E. Huber ,
Carla E. Woodmansee ,
Silvia Costa ,
Pamela S. Falk  and
C. Glen Mayhall
Barbara S. Reisner*
Affiliation:
Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, Texas
Stephanie Shaw
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch at Galveston, Galveston, Texas
Mary E. Huber
Affiliation:
Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, Texas
Carla E. Woodmansee
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch at Galveston, Galveston, Texas
Silvia Costa
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch at Galveston, Galveston, Texas
Pamela S. Falk
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch at Galveston, Galveston, Texas
C. Glen Mayhall
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas Department of Healthcare Epidemiology, University of Texas Medical Branch at Galveston, Galveston, Texas
*
301, University Blvd, Galveston, TX 77555-0740
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Abstract

Objective:

To establish an efficient and sensitive technique for recovering vancomycin-resistant enterococci (VRE) from perianal and environmental samples collected during implementation of control measures for an outbreak of VRE.

Design:

Perianal and environmental samples were collected in triplicate on sterile swabs. One swab was used to inoculate a selective broth medium containing 6 μg of vancomycin and 8 μg of ciprofloxacin per mL, one to inoculate Campylobacter agar containing 10 μg/mL of vancomycin, and one to inoculate Enterococcosel agar containing 8 μg/mL of vancomycin.

Setting:

Samples were collected in the intensive care units of a 600-bed university hospital over a period of 2 months.

Sample Selection:

Patients and their immediate environment were sampled if they resided in a ward with a patient known to be colonized or infected with VRE.

Results:

Of the 88 perianal samples obtained from 63 patients, 37 were positive for VRE by broth culture, with 36 also recovered on both types of solid media (sensitivity, 97.3%; negative predictive value, 98.1%). Of the initial samples collected from each of the 63 patients, 20 were positive for VRE by all methods. Of the 500 environmental samples cultured, 139 were positive for VRE in broth, with only 33 recovered on Campylobacter agar (sensitivity, 23.7%; negative predictive value, 77.2%) and 22 on Enterococcosel agar (sensitivity, 15.8%; negative predictive value, 75.2%).

Conclusions:

Our data indicate that, when performing surveillance cultures during an outbreak of VRE, use of an enrichment broth medium is required to recover VRE contaminating environmental surfaces; however, direct inoculation to selective solid medium is adequate to recover VRE in patient perianal specimens.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 12 , December 2000 , pp. 775 - 779
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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References

1.Uttley, AHC, Collins, CH, Naidoo, J, George, RC. Vancomycin-resistant enterococci. Lancet 1988;1:57–58.Google Scholar
2.Karanfil, LV, Murphy, M, Josephson, A, Gaynes, R, Mandel, L, Hill, BC, et al. A duster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195–200.CrossRefGoogle Scholar
3.Livornese, LL Jr, Dias, S, Samel, C, Romanowski, B, Taylor, S, May, P, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.CrossRefGoogle ScholarPubMed
4.Rubin, LG, Tucci, V, Cercenado, E, Eliopoulos, G, Isenberg, HD. Vancomycin-resistant Enterococcus faecium in hospitalized children. Infect Control Hosp Epidemiol 1992;13:700–705.CrossRefGoogle ScholarPubMed
5.Handwerger, S, Raucher, B, Altarac, D, Monka, J, Marchione, S, Singh, KV, et al. Nosocomial outbreak due to Enterococcus faecium highly resistant to vancomycin, penicillin, and gentamicin. Clin Infect Dis 1993;16:750–755.CrossRefGoogle ScholarPubMed
6.Boyce, JM, Opal, SM, Chow, JW, Zervos, MJ, Potter-Bynoe, G, Sherman, CB, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.CrossRefGoogle ScholarPubMed
7.Morris, JG Jr, Shay, DK, Hebden, JN, McCarter, RJ Jr, Perdue, BE, Jarvis, W, et al. Enterococci resistant to multiple antimicrobial agents, including vancomycin. Establishment of endemicity in a university medical center. Ann Intern Med 1995;123:250–259.CrossRefGoogle Scholar
8.Uttley, AH, George, RC, Naidoo, J, Woodford, N, Johnson, AP, Collins, CH, et al. High-level vancomycin-resistant enterococci causing hospital infections. Epidemiol Infect 1989;103:173–181.CrossRefGoogle ScholarPubMed
9.Jordens, JZ, Bates, J, Griffiths, DJ. Fecal carriage and nosocomial spread of vancomycin-resistant Enterococcus faecium. J Antimicrob Chemother 1994;34:515–528.Google Scholar
10.Chadwick, PR, Oppenheim, BA, Fox, AWoodford, N, Morgenstern, GR, Scarffe, JH. Epidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit. J Hosp Infect 1996;34:171–182.Google Scholar
11.Brown, AR, Amyes, SG, Paton, R, Plant, WD, Stevenson, GM, Winney, RJ, et al. Epidemiology and control of vancomycin-resistant enterococci (VRE) in a renal unit. J Hosp Infect 1998;40:115–124.CrossRefGoogle Scholar
12.Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597–599.Google Scholar
13.Bonten, MJ, Hayden, MK, Nathan, C, Van Voorhis, J, Matushek, M, Slaughter, S, et al. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 1996;348:1615–1619.Google Scholar
14.Noskin, GA, Stosor, V, Cooper, I, Peterson, LR, Recovery of vancomycin-resistant enterococci on fingertips and environmental surfaces. Infect Control Hosp Epidemiol 1995;16:577–581.Google Scholar
15.Bonilla, HF, Zervos, MJ, Kauffman, CA. Long-term survival of vancomycin-resistant Enterococcus faecium on a contaminated surface. Infect Control Hosp Epidemiol 1996;17:770–771.CrossRefGoogle ScholarPubMed
16.Falk, PS, Winnike, J, Woodmansee, C, Desai, M, Mayhall, CG. Outbreak of vancomycin-resistant enterococci in a burn unit. Infect Control and Hosp Epidemiol 2000;21:575–582.Google Scholar
17.Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105–113.Google Scholar
18.Weinstein, JW, Tallapragada, S, Farrel, P, Dembry, LM. Comparison of rectal and perirectal swabs for detection of colonization with vancomycin resistant enterococci. J Clin Microbiol 1996;34:210–212.CrossRefGoogle ScholarPubMed
19.Taylor, ME, Oppenheim, BA, Chadwick, PR, Weston, D, Palepou, MF, Woodford, N, et al. Detection of glycopeptide resistant enterococci in routine diagnostic faeces specimens. J Hosp Infect 1999;43:25–32.Google Scholar
20.Ieven, M, Vercauteren, E, Descheemaeker, P, Van Laer, F, Goossens, H. Comparison of direct plating and broth enrichment culture for the detection of intestinal colonization by glycopeptide-resistant enterococci among hospitalized patients. J Clin Microbiol 1999;37:1436–1440.CrossRefGoogle ScholarPubMed
21.Landman, D, Quale, JM, Oydna, E, Willey, B, Ditore, V, Zaman, M, et al. Comparison of five selective media for identifying fecal carriage of vancomycin-resistant enterococci. J Clin Microbiol 1996;34:751–752.Google Scholar
22.Ford, M, Perry, JD, Gould, FK, Orr, KE. Neomycin blood agar as a selective medium for vancomycin-resistant Enterococcus faecium. J Clin Pathol 1996;49:437.Google Scholar
23.Edberg, SC, Hardalo, CJ, Kontnick, C, Campbell, S. Rapid detection of vancomycin-resistant enterococci. J Clin Microbiol 1994;32:2182–2184.Google Scholar
24.Ford, M, Perry, JD, Gould, FK. Use of cephalexin-aztreonam-arabinose agar for selective isolation of Enterococcus faecium. J Clin Microbiol 1994;32:2999–3001.CrossRefGoogle ScholarPubMed
25.Chadwick, PR, Oppenheim, BA. Neomycin blood agar as a selective medium for vancomycin resistant Enterococcus faecium. J Clin Pathol 1995;48:1068–1070.Google Scholar
26.Rao, GG, Ghanekar, K, Ojo, F. Selective medium for screening for vancomycin-resistant enterococci in faeces. Eur J Clin Microbiol Infect Dis 1996;15:175–177.Google Scholar
27.Barton, ALDoern, GV. Selective media for detecting gastrointestinal carriage of vancomycin-resistant enterococci. Diagn Microbiol Infect Dis 1995;23:119–122.CrossRefGoogle ScholarPubMed
28.Van Horn, KG, Gedris, CA, Rodney, KM. Selective isolation of vancomycin-resistant enterococci. J Clin Microbiol 1996;34:924–927.Google Scholar