The impact of vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated VRE bacteremia.

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  • Additional Information
    • Source:
      Publisher: Cambridge University Press Country of Publication: United States NLM ID: 8804099 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-6834 (Electronic) Linking ISSN: 0899823X NLM ISO Abbreviation: Infect Control Hosp Epidemiol Subsets: MEDLINE
    • Publication Information:
      Publication: Jan. 2015- : Cambridge : Cambridge University Press
      Original Publication: [Thorofare, N.J. ] : SLACK Inc., c1988-
    • Subject Terms:
      Bacteremia*/diagnosis ; Bacteremia*/epidemiology ; Bacteremia*/prevention & control ; Cross Infection*/diagnosis ; Cross Infection*/epidemiology ; Cross Infection*/prevention & control ; Gram-Positive Bacterial Infections*/diagnosis ; Gram-Positive Bacterial Infections*/epidemiology ; Gram-Positive Bacterial Infections*/prevention & control ; Vancomycin-Resistant Enterococci*/genetics; Delivery of Health Care ; Humans ; Incidence ; Policy ; Vancomycin
    • Abstract:
      Objective: To evaluate the impact of a vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated (HA)-VRE bacteremia in an endemic hospital setting.
      Design: A quasi-experimental before-and-after study.
      Setting: A 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.
      Methods: Since May 2010, our hospital has diminished VRE screening for admitted patients transferred from other healthcare facilities. We assessed the impact of this policy change on the incidence of HA-VRE bacteremia using segmented autoregression analysis of interrupted time series from January 2006 to December 2014 at the hospital and unit levels. In addition, we compared the molecular characteristics of VRE blood isolates collected before and after the screening policy change using multilocus sequence typing and pulsed-field gel electrophoresis.
      Results: After the VRE screening policy change, the incidence of hospital-wide HA-VRE bacteremia increased, although no significant changes of level or slope were observed. In addition, a significant slope change in the incidence of HA-VRE bacteremia (change in slope, 0.007; 95% CI, 0.001-0.013; P = .02) was observed in the hemato-oncology department. Molecular analysis revealed that various VRE sequence types appeared after the policy change and that clonally related strains became more predominant (increasing from 26.1% to 59.3%).
      Conclusions: The incidence of HA-VRE bacteremia increased significantly after VRE screening policy change, and this increase was mainly driven by high-risk patient populations. When planning VRE control programs in hospitals, different approaches that consider risk for severe VRE infection in patients may be required.
    • Accession Number:
      6Q205EH1VU (Vancomycin)
    • Publication Date:
      Date Created: 20210517 Date Completed: 20220517 Latest Revision: 20220719
    • Publication Date:
      20231215
    • Accession Number:
      10.1017/ice.2021.189
    • Accession Number:
      33993892