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Korean J healthc assoc Infect Control Prev 2021; 26(1): 16-23

Published online June 30, 2021 https://doi.org/10.14192/kjicp.2021.26.1.16

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

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It Is Time to Address the Isolation Policy for Patients Colonized with Vancomycin-resistant Enterococci

Euijin Chang1, Hong Bin Kim2,3

Division of Infection Diseases, Seoul National University Hospital1, Seoul, Division of Infectious Diseases, Seoul National University Bundang Hospital2, Seongnam, Department of Internal Medicine, Seoul National University College of Medicine3, Seoul, Korea

Correspondence to: Hong Bin Kim
E-mail: hbkimmd@snu.ac.kr
ORCID: https://orcid.org/0000-0001-6262-372X

Received: April 27, 2021; Revised: May 31, 2021; Accepted: May 31, 2021

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).

Abstract

Vancomycin-resistant enterococci (VRE) are one of the most important pathogens causing healthcare-associated infections. If VRE is detected in the culture tests of a patient’s clinical specimen, the patient should be isolated in a single room (preferred to a cohort room), and contact precautions should be initiated based on the infection control guidelines for multidrugresistant organisms by the Korea Disease Control and Prevention Agency. VRE is known to transmit vancomycin resistance genes to other bacteria; hence, isolation of VRE-colonized patients is recommended. However, many studies have shown that the probability of the spread of vancomycin resistance genes from VRE to other bacteria is rare and that the discontinuation of isolation and contact precaution does not significantly increase the rate of VRE colonization or infection. Notably, the healthcare qualities for diagnosis and treatment were more improved in the group without isolation than in the group with isolation. Further investigations on the effects of discontinuing the isolation of VRE-colonized patients are warranted, because the characteristics of the Korean healthcare system are distinct from those of other countries. The study designs of quasi-experimental studies, which do not require randomization for analysis, would be useful in conducting studies on the effects of discontinuing the isolation of VRE-colonized patients. Considering the results of the previous and future studies and the unique features of the Korean healthcare system, the isolation protocols could be relaxed gradually and applied only to specific cases, such as residents of nursing hospitals and immunosuppressed patients.

Keywords: Vancomycin-resistant enterococci, Isolation, Infection control

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