Horizontal infection prevention measures and a risk-managed approach to vancomycin-resistant enterococci: An evaluation
| Autor: | Sydney Scharf, Jennifer Grant, Linda Dempster, Felicia Laing, Elizabeth Bryce, Salomeh Shajari, Tim T Y Lau, Leslie Forrester |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Isolation (health care) Epidemiology Vancomycin-Resistant Enterococci Intensive care Disease Transmission Infectious Medicine Infection control Antimicrobial stewardship Humans Intensive care medicine Gram-Positive Bacterial Infections Cross Infection Infection Control business.industry Health Policy Public Health Environmental and Occupational Health biochemical phenomena metabolism and nutrition Clostridium difficile bacterial infections and mycoses medicine.disease Drug Utilization Anti-Bacterial Agents Infectious Diseases Increased risk Bacteremia Emergency medicine business |
| Zdroj: | American journal of infection control. 43(11) |
| ISSN: | 1527-3296 |
| Popis: | Background: The use of infection control measures in the management of vancomycin-resistant enterococci (VRE) is hotly debated. A risk-managed approach to VRE control after the introduction of 2 horizontal infection prevention measuresdan environmental cleaning (EC) and an antimicrobial stewardship (AMS) programdwas assessed. Methods: Routine screening for VRE was discontinued 6 and 4 months after introduction of the EC and AMS programs, respectively. Only 4 units (intensive care, burns-trauma, solid organ transplant, and bone marrow transplant units) where patients were deemed to be at increased risk for VRE infection continued screening and contact precautions. Cost avoidance and value-added benefits were monitored by the hospital finance department. VRE monitoring on these high-risk units and facility-wide comprehensive bacteremia surveillance continued as per established protocols. Surveillance for methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile infection (CDI) remained unchanged. Results: VRE bacteremia rates did not increase with the change to the VRE risk-managed approach. The number of patients requiring VRE isolation in all areas of the hospital decreased from an average of 32 to 6 beds per day. Statistically significant reductions in CDI and MRSA rates were observed possibly related to the aggressive decluttering, equipment cleaning, and AMS program elements. Conclusion: A risk-managed approach to VRE can be implemented without adverse consequences and potentially with significant benefits to a facility. |
| Databáze: | OpenAIRE |
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