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Control of Vancomycin‐Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting
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Abstract(back to top)
OBJECTIVE. To evaluate the efficacy of patient and staff cohorting to control vancomycin‐resistant enterococci (VRE) at an Indianapolis community hospital.
DESIGN. To interrupt transmission of VRE, a VRE pointprevalence survey of hospital inpatients was conducted, and VREinfected or ‐colonized patients were cohorted on a single ward with dedicated nursing staff and patient‐care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point‐prevalence survey was repeated 2 months after the cohort ward was established.
RESULTS. Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients, P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients, P=.002); and observed staff‐patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions, P<.0001).
CONCLUSIONS. Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.
Bibliographic Information(back to top)
- Control of Vancomycin‐Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting
- Elise M. Jochimsen , MD, Laurie Fish , RN, Kelly Manning , RN, Sally Young , RN, Daniel A. Singer , MD, Robert Baker , MD and William R. Jarvis , MD
- Infection Control and Hospital Epidemiology
- Vol. 20, No. 2 (February 1999) (pp. 106-109)
Notes and References(back to top)
This item contains 1 note(s).
Notes
From the Hospital Infections Program (Drs. Jochimsen, Singer, and Jarvis), National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and the Community Hospital East (Dr. Baker, Ms. Fish, Ms. Manning, and Ms. Young), Indianapolis, Indiana. The authors are indebted to the following people for their assistance in this investigation: Mr. Paul Gielerak at Community Hospital East, Indianapolis, Indiana; Dr. Ronald N. Jones and Dr. Michael A. Pfaller at the University of Iowa, Iowa City, Iowa; Dr. Danae Bixler, Ms. Julia Butwin, Dr. Robert Teclaw, and Dr. Gregory Steele at the Indiana State Department of Health, Indianapolis, Indiana; and Dr. Shailen N. Banerjee, Dr. Matthew Arduino, Ms. Sonia Aguero, Ms. Bertha Hill, Ms. Loretta Carson, and Dr. Fred Tenover at the Centers for Disease Control and Prevention, Atlanta, Georgia. Use of trade names and commercial sources is for identification purposes only and does not imply endorsement by the Public Health Service or the US Department of Health and Human Services. Address reprint requests to Elise M. Jochimsen, MD, Hospital Infections Program, Mailstop E‐69, Centers for Disease Control and Prevention, Atlanta, GA 30333. 98‐OA‐098. Jochimsen EM, Fish L, Manning K, Young S, Singer DA, Baker R, Jarvis WR. Control of vancomycin‐resistant enterococci at a community hospital: efficacy of patient and staff cohorting. Infect Control Hosp Epidemiol 1999;20:106‐109.
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