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  • Online Resource  (2)
  • Mount Sinai Hospital Infection Control Team  (2)
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    Online Resource
    Online Resource
    Factors Associated With Acquisition of Vancomycin-Resistant Enterococci (VRE) in Roommate Contacts of Patients Colonized or Infected with VRE in a Tertiary Care Hospital
    Cambridge University Press (CUP) ; 2008
    In:  Infection Control & Hospital Epidemiology Vol. 29, No. 5 ( 2008-05), p. 398-403
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 29, No. 5 ( 2008-05), p. 398-403
    Abstract: Most nosocomial acquistion of vancomycin-resistant enterococci (VRE) is due to cross-transmission. We sought to identify risk factors for acquisition of VRE by roommates of patients colonized or infected with VRE. Design. Retrospective cohort study. Setting. A 472-bed tertiary care teaching hospital. Methods. All patients who shared a room with a patient colonized or infected with VRE at our hospital between January 1, 1999 and December 31, 2006 were identified. These roommates of VRE-positive patients were screened by rectal swab culture on days 2, 5, and 7 after the last exposure to the index patient. Chart reviews were performed to identify risk factors for VRE colonization in these roommates. Results. Eighty-eight roommates of patients colonized or infected with VRE were identified. Of the 38 roommates with complete follow-up, 8 (21%) became colonized with VRE. These 8 roommates were older (median, 87.5 vs 62.5 years of age; P = .001), had longer duration of room exposure (median, 8.5 vs 4 days; P = .002), and were more likely to have a urinary catheter (odds ratio [OR], 16 [95% confidence interval {CI}, 1.7-152] ; P = .005), an elevated serum creatinine level (OR, 17 [95% CI, 1.4-196]; P = .02), low serum albumin level (OR, 9.9 [95% CI, 1.3-113]; P = .01), and recent third-generation cephalosporin use (OR, 8.3 [95% CI, 1.5-47]; P = .02). Conclusion. Roommates of patients identified as colonized or infected with VRE are at substantial risk of becoming colonized, with the degree of risk increasing in older and more frail patients. VRE control programs should pay particular attention to such patients.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/587187
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2008
    detail.hit.zdb_id: 2106319-9
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  • 2
    Online Resource
    Online Resource
    Risk Factors for Methicillin-Resistant Staphylococcus aureus (MRSA) Acquisition in Roommate Contacts of Patients Colonized or Infected With MRSA in an Acute-Care Hospital
    Cambridge University Press (CUP) ; 2008
    In:  Infection Control & Hospital Epidemiology Vol. 29, No. 7 ( 2008-07), p. 600-606
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 29, No. 7 ( 2008-07), p. 600-606
    Abstract: To identify risk factors for acquisition of methicillin-resistant Staphylococcus aureus (MRSA) in patients exposed to an MRSA-colonized roommate. Design. Retrospective cohort study. Setting. A 472-bed acute-care teaching hospital in Toronto, Canada. Patients. Inpatients who shared a room between 1996 and 2004 with a patient who had unrecognized MRSA colonization. Methods. Exposed roommates were identified from infection-control logs and from results of screening for MRSA in the microbiology database. Completed follow-up was defined as completion of at least 2 sets of screening cultures (swab samples from the nares, the rectum, and skin lesions), with at least 1 set of samples obtained 7–10 days after the last exposure. Chart reviews were performed to compare those who did and did not become colonized with MRSA. Results. Of 326 roommates, 198 (61.7%) had completed follow-up, and 25 (12.6%) acquired MRSA by day 7–10 after exposure was recognized, all with strains indistinguishable by pulsed-field gel electrophoresis from those of their roommate. Two (2%) of 101 patients were not colonized at day 7–10 but, with subsequent testing, were identified as being colonized with the same strain as their roommate (one at day 16 and one at day 18 after exposure). A history of alcohol abuse (odds ratio [OR], 9.8 [95% confidence limits {CLs}, 1.8, 53] ), exposure to a patient with nosocomially acquired MRSA (OR, 20 [95% CLs, 2.4,171]), increasing care dependency (OR per activity of daily living, 1.7 [95% CLs, 1.1, 2.7] ), and having received levofloxacin (OR, 3.6 [95% CLs, 1.1,12]) were associated with MRSA acquisition. Conclusions. Roommates of patients with MRSA are at significant risk for becoming colonized. Further study is needed of the impact of hospital antimicrobial formulary decisions on the risk of acquisition of MRSA.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/588567
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2008
    detail.hit.zdb_id: 2106319-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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