Document Detail


Recurrence of vancomycin-resistant Enterococcus stool colonization during antibiotic therapy.
MedLine Citation:
PMID:  12186208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that antibiotic therapy may promote recurrence of vancomycin-resistant Enterococcus (VRE) stool colonization in patients who have previously had three consecutive negative stool cultures obtained at least 1 week apart. DESIGN: One-year prospective cohort study examining the effect of antibiotic therapy on recurrence and density of VRE stool colonization in patients who have cleared colonization. Pulsed-field gel electrophoresis (PFGE) was performed to determine whether recurrent VRE strains were the same clone as the previous colonizing strain. SETTING: A Department of Veterans Affairs medical center including an acute care hospital and nursing home. PATIENTS: All patients with at least one stool culture positive for VRE who subsequently had three consecutive negative stool cultures obtained at least 1 week apart. RESULTS: Of the 16 patients who cleared VRE colonization, 13 received antibiotic therapy during the study period. Eight (62%) of the 13 patients who received antibiotics developed recurrent high-density VRE stool colonization (range, 4.9 to 9.1 log10 colony-forming units per gram) during a course of therapy. Five patients had VRE strains available for PFGE analysis; recurrent strains were unrelated to the prior strain in 3 patients, closely related in 1 patient, and indistinguishable in 1 patient. CONCLUSIONS: Antibiotic therapy may be associated with recurrent high-density VRE stool colonization in many patients who have previously had three consecutive negative stool cultures. These patients should be screened for recurrent stool colonization when antibiotic therapy is administered.
Authors:
Curtis J Donskey; Claudia K Hoyen; Sarbani M Das; Marion S Helfand; Michelle T Hecker
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  23     ISSN:  0899-823X     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-20     Completed Date:  2002-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-40     Citation Subset:  IM; N    
Affiliation:
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio 44106, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Bacterial Agents / adverse effects*
Case-Control Studies
Cross Infection / drug therapy*,  epidemiology
Enterococcus / drug effects*
Gram-Positive Bacterial Infections / drug therapy*,  epidemiology
Humans
Ohio / epidemiology
Prospective Studies
Recurrence
Statistics, Nonparametric
Vancomycin Resistance*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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