Control of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region

• Published in: The New England journal of medicine Vol. 344; no. 19; pp. 1427 - 1433
• Main Authors: Ostrowsky, Belinda E, Trick, William E, Sohn, Annette H, Quirk, Stephen B, Holt, Stacey, Carson, Loretta A, Hill, Bertha C, Arduino, Matthew J, Kuehnert, Matthew J, Jarvis, William R
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 10.05.2001
• Subjects: Adult; Anal Canal - microbiology; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Case-Control Studies; Colony Count, Microbial; Digestive System - microbiology; Disease control; Disease Transmission, Infectious - prevention & control; Enterococcus faecium - drug effects; Enterococcus faecium - isolation & purification; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - prevention & control; Gram-Positive Bacterial Infections - transmission; Health Facilities; Health Surveys; Hospitals; Human bacterial diseases; Humans; Infection Control - methods; Infectious diseases; Medical sciences; Midwestern United States - epidemiology; Nosocomial infections; Ostomy; Patients; Prevalence; Risk Factors; Task forces; Vancomycin Resistance; Midwestern United States; South Dakota; Iowa; United States > US; Nebraska; Enterococcus; Human; Evaluation; Operation; Gastrointestinal; Infection; Streptococcaceae; Health center; Regional study; Health policy; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Micrococcales; Public health; Gastric disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM200105103441903

During the past decade, vancomycin-resistant enterococci have emerged and become endemic at many health care facilities in the United States. 1 – 6 A major impediment to control is the large, unrecognized population of patients who are colonized with vancomycin-resistant enterococci and who thus can serve as a reservoir for transmission. 7 – 9 Colonization with vancomycin-resistant enterococci has been associated with progression to infection. 8 Studies suggest that once vancomycin-resistant enterococci are introduced in a facility, and particularly after they have spread to multiple patients or wards, control is very difficult. 6 – 8 Between December 1996 and April 1997, the number of isolates of vancomycin-resistant . . .