CDC Tracks Hospital-Acquired Infections Caused by Vancomycin-Resistant Enterococci VRE
CDC data shows that the number of hospital-acquired infections caused by VRE has doubled since 2011. A bacterial strain of the genus Enterococcus that is resistant to the antibiotic vancomycin is the cause of these infections. These bacteria can spread through direct contact with contaminated surfaces and equipment.
Bacteremia
Several studies have shown that bacteremia due to vancomycin-resistant Enterococci (VRE) is associated with increased mortality. The mortality rate associated with bacteremia was found to be between 20 and 46%. The risk factors for VRE infection include the use of broad-spectrum antibiotics, urinary tract infection, C difficile infection, invasive catheter, malignancy, and diabetes. These risk factors can result in increased mortality when patients do not receive appropriate antibiotic treatment. Consequently, the development of resistance may prevent the effectiveness of any antibiotic regimen.
In a study of hospitalized patients, vancomycin-resistant Enterococcus faecalis bacteremia was associated with increased mortality. This was particularly true in neutropenic cancer patients.
The study used a matched case-cohort approach to investigate the relationship between vancomycin resistance and clinical outcome. The match was based on the calendar date of admission and the hospital ward. The standardized measure of disease severity was not used in the matching process.
The primary site of isolation was an intra-abdominal infection in 17 percent of the cases, while urinary tract infections were observed in 31 percent. The hospital medical information system included the antimicrobial treatment history. The number of drugs used and the duration of treatment was measured. The total length of hospitalization was longer in patients with VREF bacteremia than in the control group. Longer hospitalization was also associated with a higher probability of death.
In a second study, vancomycin-resistant Enterococcus was treated in neutropenic patients. The authors of this study concluded that vancomycin resistance may be a determinant of mortality in these patients. In addition, the results of this study indicate that vancomycin-resistant Enterococcus has a higher probability of causing polymicrobial bacteremia than vancomycin-susceptible Enterococci. However, this does not mean that vancomycin-resistant Enterococcus should be used in these patients.
A third study found that vancomycin resistance was not a significant predictor of mortality. This was despite a high prevalence of VRE-associated deaths in the study population. The study was conducted at a level-one trauma center.
The study revealed that the duration of hospitalization for patients with vancomycin-resistant enterococci was higher and the mortality rates were higher than those for vancomycin-susceptible Enterococci. The study also showed that vancomycin-resistant enterococci were more common than linezolid in treating bloodstream infections. The findings suggest that linezolid is not effective in the treatment of vancomycin-resistant enterococcal bacteremia.
Spread through contact with contaminated surfaces or equipment
Intensive care unit (ICU)-acquired infections have become a global health challenge. These pathogens are a significant contributor to morbidity and mortality. Infections are most common in patients with a long hospital stay. These patients are at high risk for infection from multidrug-resistant (MDR) bacteria. ICUs are often crowded with equipment that may carry these bacteria, leading to the occurrence of cross-transmission.
Previously, surface contamination was thought to play a minor role in the transmission of healthcare-associated infections. However, recent studies have shown that major nosocomial pathogens are transmitted by the patient. This suggests that improving environmental hygiene should include reducing pathogen shedding and decontaminating items after transport.
The best way to prevent the spread of infectious diseases is to protect the respiratory secretions of the infected patient. This includes using a surgical mask. Wearing a gown is also recommended. It’s also important to keep in mind that many microorganisms are constantly shedding onto the surfaces of the environment.
The same genetic profile of isolates has been found to be associated with environmental contamination. These findings suggest that a low infectious dose of pathogens might be needed to transmit the microorganisms to other patients. Despite this, the number of culture-positive body sites has been found to correlate with the frequency of contamination.
The best practice for mitigating this type of exposure is to clean and disinfect the area immediately after a patient’s departure. This can be achieved by using a general disinfectant. It is also important to make sure that the equipment in the healthcare area is thoroughly disinfected after entering the patient zone. Various types of equipment, including portable radiograph equipment, may be introduced into the patient zone for therapeutic purposes.
Identifying contamination sites can help inform infection control practices and promote new interventions. In particular, surfaces with porous materials, such as cardboard and cloth, can draw away moisture and make them less friendly to pathogens.
The best way to prevent the spread, of both of these major pathogens, is to adopt strict hand hygiene measures. These should include the proper use of gloves and a surgical mask.
CDC track data on hospital-acquired infections
CDC track data on hospital-acquired infections caused by vancomycin-resistant Enterococci, or VRE. These bacteria are normally present in the human gastrointestinal tract but can cause infection when they are exposed to antibiotics. They may also be found in the environment. However, their resistance to certain antibiotics makes them difficult to treat. Therefore, preventing them from causing infections is important. In addition, there are several prevention strategies that hospitals can use to reduce the risk of VRE.
In order to prevent transmission of VRE, healthcare facilities should implement screening for the disease. This can be done through intensified fecal screening of enterococci isolates. This approach can help identify colonized patients earlier and may lead to more efficient containment of the microorganism. These screenings should be restricted to patients with a substantial risk of colonization.
The increase in the number of hospital-acquired infections caused by VRE was driven primarily by a 34-fold increase in the percentage of VRE infections among intensive-care patients. In addition, the percentage of VRE infections among extended-spectrum b-lactamase-producing Enterobacterales was one-third higher than in the previous year. These numbers reflect the increased incidence of vancomycin-resistant Enterococcus infections and are accompanied by an increase in other antimicrobial-resistant infections.
Using NHSN data, the CDC tracked a number of HAIs, including infections caused by bacteria, fungi, parasites, and viruses. The data were reported by healthcare facilities in all 50 states. These hospitals voluntarily reported their infection rates in response to state reporting requirements. These reports were then used by the CDC to calculate the standardized infection ratios or SIRs.
The CDC will continue to track and research these infections and develop prevention strategies to prevent them. In addition, the Center works with state and local health departments to respond to outbreaks. During an outbreak, CDC provides infection prevention expertise, conducts research, and responds to requests for help. It also works with hospitals to develop and implement infection prevention programs.
The National Healthcare Safety Network is a national program that tracks important processes in the healthcare system. The CDC uses NHSN to report data, perform surveillance, and help improve the quality of care.
Prevention
Several studies have shown that vancomycin-resistant enterococci (VRE) can cause an increased risk of hospital-acquired infections. This type of infection is associated with high attributable mortality rates and high costs. The National Committee for Clinical Laboratory Standards (NCCLS) has issued recommendations for the detection and treatment of VRE. The Hospital Infection Control Practices Advisory Committee (HICPAC) ratified these recommendations in November 1994.
Infection control recommendations for hospitalized patients include testing enterococcal isolates for resistance to vancomycin. Healthcare providers choose the antibiotic to treat a patient based on the antibiotic’s activity and side effects. However, the use of vancomycin for prophylaxis in patients with methicillin-susceptible gram-positive infections without a penicillin allergy is not recommended.
VRE can be transmitted indirectly through the environment and patient-to-patient contact. It is also possible to spread the organism through contaminated surfaces and equipment. Using isolation precautions and implementing a handwashing program is important to prevent the transmission of VRE.
Infection control programs should be enhanced in facilities that are at high risk. Critically ill patients and those with catheters are at particular risk. In addition, intensive screening of feces should be performed on patients with a high risk for colonization. This can lead to earlier identification of colonized patients and more effective containment of the microorganism.
The BD GeneOhm VanR assay is an in vitro polymerase chain reaction (PCR) test that can detect the genes that cause vancomycin resistance directly from swabs. This assay can be used to identify vancomycin-resistant organisms, which can reduce the length of stay and decrease healthcare costs.
In the United States, vancomycin-resistant enterococci account for 30% of hospital-acquired enterococcal infections. In the United States, the number of VRE-associated infections has increased steadily since 1987. The incidence of VRE in non-ICU patients has increased from 0.4% to 13.6%.
In Australia, the rate of vancomycin resistance in E. faecium is one of the highest in the country. This is attributed to the high rate of hospitalization and the use of intravenous and oral antibiotics. A national surveillance system, the Antimicrobial Use and Resistance in Australia (AURA), monitors the occurrence of VRE.
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