Preventing the spread of vancomycin-resistant enterococci in a long-term care facility
| Autor: | Julia Blazek-D'Arezzo, Josephine Alves, Fredric J. Silverblatt, Marc Tack, Paul Agatiello, Cynthia Tibert, Dennis J. Mikolich |
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| Rok vydání: | 2000 |
| Předmět: |
Male
Patient Transfer medicine.medical_specialty Isolation (health care) Endemic Diseases Hospitals Veterans Prevalence Administration Oral Bacitracin Risk Factors Acute care medicine Infection control Humans Colonization Intensive care medicine Gram-Positive Bacterial Infections Antibacterial agent Aged Skilled Nursing Facilities Infection Control business.industry Rectum Rhode Island Vancomycin Resistance biochemical phenomena metabolism and nutrition United States Anti-Bacterial Agents Long-term care United States Department of Veterans Affairs Case-Control Studies Emergency medicine Chemoprophylaxis Carrier State Female Geriatrics and Gerontology business Enterococcus |
| Zdroj: | Journal of the American Geriatrics Society. 48(10) |
| ISSN: | 0002-8614 |
| Popis: | OBJECTIVES: To test the hypothesis that infection control practices can prevent the spread of vancomycin-resistant enterococci (VRE) to residents of a long-term care facility (LCF) from an affiliated acute care facility with a high endemic rate of colonization. DESIGN: Point prevalence study of the rate of rectal colonization. SETTING: A state-supported veterans nursing home and an acute care veterans hospital. PARTICIPANTS: Residents in a state veterans home. INTERVENTIONS: Identification of patients with rectal colonization by VRE before transfer to the state veterans home, contact isolation for colonized veterans, use of oral bacitracin to eliminate colonization. MEASUREMENTS: Rectal swab and culture for VRE, review of clinical records and recording of presumptive risk factors for VRE colonization. The risk factors were age, gender, length of stay at nursing home, treatment with vancomycin or oral antibiotics, prior hospitalization at the acute care facility during the prior year, use of indwelling urethral catheters, presence of diarrhea, and fecal or urinary incontinence. RESULTS: Sixty-nine of 200 residents were cultured in the first study (1996) and 130 of 230 residents were cultured in the second study (1998). Residents who consented to culture differed from those who did not only with regards to gender (2 vs 7, P = .012). In neither study were any residents found to be colonized with VRE who had not already been identified as positive on admission. CONCLUSIONS: Adherence to infection control practices by the patient care staff of the LTCF was associated with the absence of transmission of VRE colonization among its residents. The presence of rectal colonization with VRE in an acute care patient should not be a barrier to acceptance in a nursing home. |
| Databáze: | OpenAIRE |
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