Skip to main content
×
×
Home

Colonization and Infection With Multiple Nosocomial Pathogens Among Patients Colonized With Vancomycin-Resistant Enterococcus

  • Curtis J. Donskey (a1), Amy J. Ray (a1), Claudia K. Hoyen (a2), Peter D. Fuldauer (a3), David C. Aron (a4), Ann Salvator (a2) and Robert A. Bonomo (a1)...
Abstract
Objective:

To test the hypothesis that patients colonized with vancomycin-resistant Enterococcus (VRE) have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE.

Design:

A rectal swab culture survey was conducted to determine the point-prevalence of stool colonization with ceftazidime-resistant gram-negative bacilli in hospitalized patients with or without VRE stool colonization. For a 6-month period, the frequency of Clostridium difficile diarrhea and isolation of antibiotic-resistant (ie, ceftazidime-, piperacillin/tazobactam-, levofloxacin-, or trimethoprim/sulfamethoxazole-resistant) gram-negative bacilli, methicillin-resistant Staphylococcus aureus (MRSA), and non-albicans Candida species from clinical specimens other than stool was examined.

Setting:

A Department of Veterans Affairs medical center.

Patients:

All patients hospitalized in the acute care facility and one nursing home unit during a 1-week period in February 2001.

Results:

VRE-colonized patients had a higher point-prevalence of rectal colonization with ceftazidime-resistant gram-negative bacilli than did patients not colonized with VRE (17% vs 4%; P = .026). During a 6-month period, the VRE-colonized patients were more likely to have Clostridium difficile–associated diarrhea (26% vs 2%; P = .001), MRSA infection (17% vs 4%; P = .017), or colonization or infection with gram-negative bacilli resistant to 4 different antibiotics.

Conclusion:

VRE-colonized patients in our institution have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE. This suggests that isolation measures implemented to control VRE could help limit the dissemination of other, coexisting pathogens.

Copyright
Corresponding author
Louis Stokes Cleveland VA Medical Center, Infectious Diseases Section (111W), 10701 Blvd., Cleveland, OH 44106
References
Hide All
1.Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105113.
2.Gerding, DN. Is there a relationship between vancomycin-resistant enterococcal infection and Clostridium difficile infection? Clin Infect Dis 1997;25(suppl 2):S206S210.
3.Pfaller, MA. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin Infect Dis 1996;22(suppl 2):S89S94.
4.Muder, RR, Brennen, C, Drenning, SD, Stout, JE, Wagener, MM. Multiply antibiotic-resistant gram-negative bacilli in a long-term-care facility: a case-control study of patient risk factors and prior antibiotic use. Infect Control Hosp Epidemiol 1997;18:809813.
5.Paterson, DL, Yu, VL. Editorial response. Extended-spectrum B-lacta-mases: a call for improved detection and control. Clin Infect Dis 1999;29:14191422.
6.Garner, JS. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:5380.
7.National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Wayne, PA: National Committee for Clinical Laboratory Standards; 1993. Approved standard M7-A3.
8.Karnofsky, DA, Burchenal, JH. The clinical evaluation of chemothera-peutic agents in cancer. In: MacLeod, CM, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949:191205.
9.Ostrowsky, B, Steinberg, JT, Farr, B, Sohn, AH, Sinkowitz-Cochran, RL, Jarvis, WR. Reality check: should we try to detect and isolate vancomycin-resistant enterococci patients? Infect Control Hosp Epidemiol 2001;22:116119.
10.Eickhoff, TC. VRE contact precautions: is the juice worth the squeeze? Infectious Disease News 2000;13:5.
11.Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:11481153.
12.Donskey, CJ, Chowdhry, TK, Hecker, MT, et al. Effect of antibiotic therapy on the density of vancomycin-resistant enterococci in the stool of colonized patients. N Engl J Med 2000;343:19251932.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed