Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening
Abstract Background The optimal extent of screening of contact patients (CoPat) after exposure to patients infected or colonized with vancomycin-resistant enterococci (VRE) remains controversial. Methods We retrospectively developed a new risk stratification for screening patients exposed to VRE, ba...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13756-022-01089-9 |
| _version_ | 1828407513194692608 |
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| author | Andrea C. Büchler Silvio Ragozzino Melanie Wicki Violeta Spaniol Sammy Jäger Helena M. B. Seth-Smith Daniel Goldenberger Vladimira Hinic Adrian Egli Reno Frei Andreas F. Widmer |
| author_facet | Andrea C. Büchler Silvio Ragozzino Melanie Wicki Violeta Spaniol Sammy Jäger Helena M. B. Seth-Smith Daniel Goldenberger Vladimira Hinic Adrian Egli Reno Frei Andreas F. Widmer |
| author_sort | Andrea C. Büchler |
| collection | DOAJ |
| description | Abstract Background The optimal extent of screening of contact patients (CoPat) after exposure to patients infected or colonized with vancomycin-resistant enterococci (VRE) remains controversial. Methods We retrospectively developed a new risk stratification for screening patients exposed to VRE, based on data from three outbreaks—two with Enterococcus faecium vanB and one with Enterococcus faecium vanA involving 1096 CoPat—in a low endemic setting. We classified them into four risk groups: three on environmental exposure, one by healthcare exposure: high (sharing the same room/bathroom with a VRE-colonized patient), medium (hospitalization in the same room after a VRE-colonized patient’s discharge until terminal disinfection including ultraviolet C (UVc)-disinfection), low (hospitalized in the same room within three weeks before the VRE-colonized patient), and “staff” (screening of patients having the same medical care team). Results VRE-transmission occurred in 7.9% in the high-risk group compared to 0.6% and 0% in the medium and low risk groups. There was a significant trend to higher rates of transmission by risk level of exposure (p < 0.001). In the “staff” group, VRE transmission rate was 2.3%. Conclusion Based on this stratification, we recommend to focus screening of exposed CoPat on the high-risk and “staff” group, saving resources and costs, but larger studies will allow to further improve the yield of VRE screening in the outbreak setting. |
| first_indexed | 2024-12-10T11:25:53Z |
| format | Article |
| id | doaj.art-a2c3a67f37f84d7388d31561f7865d82 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-10T11:25:53Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-a2c3a67f37f84d7388d31561f7865d822022-12-22T01:50:45ZengBMCAntimicrobial Resistance and Infection Control2047-29942022-04-011111710.1186/s13756-022-01089-9Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screeningAndrea C. Büchler0Silvio Ragozzino1Melanie Wicki2Violeta Spaniol3Sammy Jäger4Helena M. B. Seth-Smith5Daniel Goldenberger6Vladimira Hinic7Adrian Egli8Reno Frei9Andreas F. Widmer10Division of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselClinical Bacteriology and Mycology, University Hospital Basel, University of BaselClinical Bacteriology and Mycology, University Hospital Basel, University of BaselClinical Bacteriology and Mycology, University Hospital Basel, University of BaselClinical Bacteriology and Mycology, University Hospital Basel, University of BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselAbstract Background The optimal extent of screening of contact patients (CoPat) after exposure to patients infected or colonized with vancomycin-resistant enterococci (VRE) remains controversial. Methods We retrospectively developed a new risk stratification for screening patients exposed to VRE, based on data from three outbreaks—two with Enterococcus faecium vanB and one with Enterococcus faecium vanA involving 1096 CoPat—in a low endemic setting. We classified them into four risk groups: three on environmental exposure, one by healthcare exposure: high (sharing the same room/bathroom with a VRE-colonized patient), medium (hospitalization in the same room after a VRE-colonized patient’s discharge until terminal disinfection including ultraviolet C (UVc)-disinfection), low (hospitalized in the same room within three weeks before the VRE-colonized patient), and “staff” (screening of patients having the same medical care team). Results VRE-transmission occurred in 7.9% in the high-risk group compared to 0.6% and 0% in the medium and low risk groups. There was a significant trend to higher rates of transmission by risk level of exposure (p < 0.001). In the “staff” group, VRE transmission rate was 2.3%. Conclusion Based on this stratification, we recommend to focus screening of exposed CoPat on the high-risk and “staff” group, saving resources and costs, but larger studies will allow to further improve the yield of VRE screening in the outbreak setting.https://doi.org/10.1186/s13756-022-01089-9Vancomycin-resistant enterococciScreeningOutbreakContact investigationsInfection control |
| spellingShingle | Andrea C. Büchler Silvio Ragozzino Melanie Wicki Violeta Spaniol Sammy Jäger Helena M. B. Seth-Smith Daniel Goldenberger Vladimira Hinic Adrian Egli Reno Frei Andreas F. Widmer Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening Antimicrobial Resistance and Infection Control Vancomycin-resistant enterococci Screening Outbreak Contact investigations Infection control |
| title | Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening |
| title_full | Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening |
| title_fullStr | Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening |
| title_full_unstemmed | Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening |
| title_short | Patients exposed to vancomycin-resistant enterococci during in-hospital outbreaks in a low endemic setting: a proposal for risk-based screening |
| title_sort | patients exposed to vancomycin resistant enterococci during in hospital outbreaks in a low endemic setting a proposal for risk based screening |
| topic | Vancomycin-resistant enterococci Screening Outbreak Contact investigations Infection control |
| url | https://doi.org/10.1186/s13756-022-01089-9 |
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