Korean J healthc assoc Infect Control Prev 2015; 20(1): 19-28
Published online June 30, 2015 https://doi.org/10.14192/kjnic.2015.20.1.19
Copyright © Korean Society for Healthcare-associated infection Control and Prevention
Dongsuk Lee1, Eun Suk Park1, Dongeun Yong2, Jun Yong Choi1,3, Kyungwon Lee2, Sun Ha Jee4
Department of Infection Control, Severance Hospital1, Department of Laboratory Medicine2, Division of Infectious Disease, Department of Internal Medicine3, Yonsei University College of Medicine, Institute for Health Promotion, Graduate School of Public Health, Yonsei University4, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Patients infected with vancomycin-resistant enterococci (VRE) are kept in isolation to prevent the spread of VRE in medical facilities. However, decision-making regarding isolation can be challenging at the time of re-admission of previously VRE-colonized or infected patients who have not been examined for VRE infections for a long time. This study focused on providing guidelines for isolating VRE patients based on the analysis of risk factors for prolonged carriage and reacquisition of VRE. Methods: A retrospective review was performed on medical records of patients who were diagnosed with VRE infections at a university hospital in 2009. Durations of colonization and negative conversion of VRE were estimated by Kaplan-Meier methods. Prolonged duration of VRE infections and risk factors for reacquisition were analyzed using Cox’s proportional hazard model.Results: Among 220 VRE-colonized patients, 132 were cleared, and 30 reacquired after negative conversion of VRE. The median duration of colonization was 33.1 weeks, and the median clearance period was 19.4 weeks. Patients who were admitted via the emergency department and treated with glycopeptides tended to have prolonged duration of VRE colonization. Prolonged hospitalization and metronidazole therapy increased the risk of reacquisition more rapidly.Conclusion: Treatment with glycopeptides, metronidazole antibiotic therapy, history of admission via the emergency department, and prolonged hospitalization can affect to prolonged carriage and reacquisition of VRE. Consider carefully the release of isolation of VRE patients with these risk factors.
Keywords: Colonization, Enterococcus, Patient isolation, Vancomycin resistance
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