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Ann Ig. 2013 Nov-Dec;25(6):485-92. doi: 10.7416/ai.2013.1948.

Vancomycin resistant enterococci healthcare associated infections.

Author information

1
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.

Abstract

BACKGROUND:

Vancomycin-resistant enterococci (VRE) are among the most common healthcare associated multidrug-resistant organisms. Purpose of the article was to review recent data regarding the epidemiology, clinical issues and infection control of this organisms.

METHODS:

A PubMed-MEDLINE search was carried out.

RESULTS:

The European Antimicrobial Resistance Surveillance System (EARSS) highlights a large variability between the various european countries, with VRE ranging from <2% (Finland, Holland) to >20% (Ireland, Greece, Portugal). Italy shows a low rate level (4.2%). In USA according to the National Healthcare Safety Network (NHSN) in 2006-2007 overall 33% of enterococci were resistant to vancomycin, whereas in Canada VRE prevalence showed to be much lower <10%. Although with some methodological limits, several studies showed that infections caused by VRE are more serious and associated to a higher mortality rate and economic burden compared to those caused by vancomycin susceptible enterococci (VSE). The average increased associated mortality was over two-fold. Resistance to newer antimicrobial agents as daptomycin and linezolid has been described, complicating treatment options for infections caused by these organisms.

CONCLUSION:

Control measures aimed at reducing the incidence of VRE colonization and infection in healthcare settings should include: hand washing with an antiseptic or a waterless antiseptic agent, routine screening for vancomycin resistance among clinical isolates, rectal surveillance cultures, contact isolation for patients with VRE and antimicrobial stewardship.

PMID:
24284534
DOI:
10.7416/ai.2013.1948
[Indexed for MEDLINE]
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