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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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