Room contamination, patient colonization pressure, and the risk of vancomycin-resistant Enterococcus colonization on a unit dedicated to the treatment of hematologic malignancies and hematopoietic stem cell transplantation - 01/10/16
, Bert K. Lopansri, MD b, c, Michaela A. Gazdik, PhD b, Brandon Webb, MD b, c, Gregory L. Snow, PhD d, Daanish Hoda, MD a, Barbara Adams, RN a, Finn Bo Petersen, MD aHighlights |
• | Transfer of VRE from room surfaces seems to be uncommon on heme/BMT units. |
• | VRE colonization pressure is a risk factor for VRE acquisition on heme/BMT units. |
• | Emphasis on staff compliance with hospital protocols may decrease VRE acquisition. |
Abstract |
Background |
Contaminated surfaces and colonization pressure are risk factors for vancomycin-resistant Enterococcus (VRE) colonization in intensive care units (ICUs). Whether these apply to modern units dedicated to the care of hematologic malignancies and hematopoietic stem cell transplant (HSCT) procedures is unknown.
Methods |
We reviewed the records of 780 consecutive admissions for acute leukemia, autologous HSCT, or allogeneic HSCT in which the patient was at risk for hospital-acquired VRE and underwent weekly surveillance. We also obtained staff and room cultures, observed staff behavior, and performed VRE molecular strain typing on selected isolates.
Results |
The overall rate of VRE colonization was 11.4 cases/1,000 patient days. Cultures of room surfaces revealed VRE isolates in 10% of terminally cleaned rooms. A prior VRE-colonized room occupant did not increase risk, and paired isolates from 20 patients and prior occupants were indistinguishable on molecular typing in only 1 pair. VRE colonization pressure was significantly associated with acquisition. Cultures of unit personnel and shared equipment were negative except for weighing scales. Observation of unit clinical personnel showed high compliance for hand sanitation and but less so for gowns. Conversely, ancillary staff showed poor compliance.
Conclusions |
Transmission of VRE from room surfaces seems to be an infrequent event. Encouraging adherence to surveillance, disinfection, and contact isolation protocols may decrease VRE colonization rates.
Le texte complet de cet article est disponible en PDF.Key Words : Acute leukemia, Environmental contamination, Healthcare worker compliance
Plan
| Author financial Disclosures: None. |
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| This study was supported by a grant (number 722) from the Intermountain Healthcare Medical and Research Foundation. |
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| Conflicts of Interest: None to report. |
Vol 44 - N° 10
P. 1110-1115 - octobre 2016 Retour au numéro
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