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An outbreak of vancomycin-resistant enterococci in a hematology-oncology unit: control by patient cohorting and terminal cleaning of the environment.

https://arctichealth.org/en/permalink/ahliterature188914
Source
Infect Control Hosp Epidemiol. 2002 Aug;23(8):468-70
Publication Type
Article
Date
Aug-2002
Author
Mary Lu Sample
Denise Gravel
Cathy Oxley
Baldwin Toye
Gary Garber
Karam Ramotar
Author Affiliation
Infection Control, The Ottawa Hospital, Ontario, Canada.
Source
Infect Control Hosp Epidemiol. 2002 Aug;23(8):468-70
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cross Infection - epidemiology - prevention & control
Disease Outbreaks - prevention & control
Disinfection - methods
Enterococcus
Gram-Positive Bacterial Infections - epidemiology - prevention & control
Humans
Infection Control - methods
Male
Oncology Service, Hospital
Ontario - epidemiology
Patient Isolation
Vancomycin Resistance
Abstract
We describe the impact of enhanced infection control interventions on controlling the spread of vancomycin-resistant enterococci (VRE) in our hematology-oncology unit. Between April and September 1998, 13 patients on this unit were identified as having VRE. In addition to contact precautions, other measures that were needed to control the outbreak included closure of the unit to new admissions, creation of a cohort of VRE-positive patients and staff, and thorough cleaning of patients' rooms with 0.5% sodium hypochlorite.
PubMed ID
12186215 View in PubMed
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Antimicrobial activity of tigecycline and comparative agents against clinical isolates of staphylococci and enterococci from ICUs and general hospital wards at three Swedish university hospitals.

https://arctichealth.org/en/permalink/ahliterature152942
Source
Scand J Infect Dis. 2009;41(3):171-81
Publication Type
Article
Date
2009
Author
Carina Claesson
Lennart E Nilsson
Göran Kronvall
Mats Walder
Mikael Sörberg
Author Affiliation
Clinical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linkoping University, Linkoping, Sweden. carcl@imk.liu.se
Source
Scand J Infect Dis. 2009;41(3):171-81
Date
2009
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - pharmacology
Bacterial Proteins - genetics
Carbon-Oxygen Ligases - genetics
Enterococcus - drug effects - genetics - isolation & purification
Hospitals, University
Humans
Intensive Care Units
Methicillin Resistance - genetics
Microbial Sensitivity Tests
Minocycline - analogs & derivatives - pharmacology
Patients' Rooms
Polymerase Chain Reaction
Staphylococcus - drug effects - genetics - isolation & purification
Statistics, nonparametric
Sweden
Vancomycin Resistance - genetics
Abstract
The activities of tigecycline and comparative agents on staphylococci and enterococci isolated from patients at general hospital wards (GHWs) and intensive care units (ICUs) at 3 university hospitals in Sweden were investigated. Oxacillin disc diffusion and minimal inhibitory concentration with E-test were used. The presence of mecA, vanA or vanB genes was determined with PCR. Statistically significant higher incidence of clindamycin, fusidic acid, rifampicin and multidrug-resistant CoNS was found at ICUs compared to GHWs. Resistance rates were low among S. aureus. Tigecycline, linezolid and vancomycin were the only agents with high activity against methicillin-resistant S. aureus and multidrug-resistant CoNS. Resistance rates were low among E. faecalis, except for high-level gentamicin-resistant (HLGR) E. faecalis. E. faecium showed high resistance rates to ampicillin, piperacillin/tazobactam and imipenem. The HLGR rates among E. faecium were lower than the rates for E. faecalis. Tigecycline and linezolid were the only drugs with high activity against all enterococci including vancomycin-resistant enterococci. No statistically significant differences in susceptibility rates were found between the ward levels for S. aureus and enterococcal isolates and no statistically significant differences were found between the hospitals.
PubMed ID
19173129 View in PubMed
Less detail
Source
CMAJ. 2002 Oct 15;167(8):885-91
Publication Type
Article
Date
Oct-15-2002
Author
John Conly
Author Affiliation
Centre for Antimicrobial Resistance, University of Calgary, Alta. jconly@ucalgary.ca
Source
CMAJ. 2002 Oct 15;167(8):885-91
Date
Oct-15-2002
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Canada - epidemiology
Cross Infection - drug therapy - epidemiology - microbiology
Drug Resistance, Microbial - genetics
Drug Utilization
Enterococcus - drug effects
Humans
Methicillin Resistance
Prevalence
Staphylococcus aureus - drug effects
Streptococcus pneumoniae - drug effects
Vancomycin Resistance
Abstract
Antibiotic resistance has increased rapidly during the last decade, creating a serious threat to the treatment of infectious diseases. Canada is no exception to this worldwide phenomenon. Data from the Canadian Nosocomial Infection Surveillance Program have revealed that the incidence of methicillin-resistant Staphylococcus aureus, as a proportion of S. aureus isolates, increased from 1% in 1995 to 8% by the end of 2000, and vancomycin-resistant enterococcus has been documented in all 10 provinces since the first reported outbreak in 1995. The prevalence of nonsusceptible Streptococcus pneumoniae in Canada in 2000 was found to be 12%. Human antimicrobial prescriptions, adjusted for differences in the population, declined 11% based on the total number of prescriptions dispensed between 1995 and 2000. There was also a 21% decrease in beta-lactam prescriptions during this same period. These data suggest that systematic efforts to reduce unnecessary prescribing of antimicrobials to outpatients in Canada, beginning after a national consensus conference in 1997, may be having an impact. There is, however, still a need for continued concerted efforts on a national, provincial and regional level to quell the rising tide of antibiotic resistance.
Notes
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PubMed ID
12406948 View in PubMed
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Antimicrobial susceptibility of 15,644 pathogens from Canadian hospitals: results of the CANWARD 2007-2009 study.

https://arctichealth.org/en/permalink/ahliterature136689
Source
Diagn Microbiol Infect Dis. 2011 Mar;69(3):291-306
Publication Type
Article
Date
Mar-2011
Author
George G Zhanel
Heather J Adam
Donald E Low
Joseph Blondeau
Melanie Decorby
James A Karlowsky
Barbara Weshnoweski
Ravi Vashisht
Aleksandra Wierzbowski
Daryl J Hoban
Author Affiliation
Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada R3E 0J9. ggzhanel@pcs.mb.ca
Source
Diagn Microbiol Infect Dis. 2011 Mar;69(3):291-306
Date
Mar-2011
Language
English
Geographic Location
Canada
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacterial Infections - microbiology
Canada
Child
Child, Preschool
Drug Resistance, Bacterial
Gram-Negative Bacteria - drug effects - isolation & purification
Gram-Positive Cocci - drug effects - isolation & purification
Hospitals
Humans
Infant
Infant, Newborn
Methicillin-Resistant Staphylococcus aureus - drug effects
Microbial Sensitivity Tests
Middle Aged
Vancomycin Resistance
beta-Lactamases
Abstract
The CANWARD study (Canadian Ward Surveillance Study) assessed the antimicrobial susceptibility of a variety of available agents against 15 644 pathogens isolated from patients in Canadian hospitals between 2007 and 2009. The most active (based on MIC data) agents against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci were daptomycin, linezolid, tigecycline, and vancomycin (MRSA only) with MIC(90)'s (µg/mL) of 0.25 and 2, 2 and 2, 0.5 and 0.12, and 1, respectively. The most active agents against extended-spectrum �-lactamase-producing Escherichia coli were colistin (polymyxin E), doripenem, ertapenem, meropenem, and tigecycline with MIC(90)'s (µg/mL) of 1, = 0.12, 0.25, = 0.12, and 1, respectively. The most active agents against Pseudomonas aeruginosa were amikacin, cefepime, ceftazidime, colistin, doripenem, meropenem, and piperacillin-tazobactam with MIC(90)'s (µg/mL) of 32, 16, 32, 2, 4, 8, and 64, respectively. Overall, the most active agents versus Gram-positive cocci from Canadian hospitals were vancomycin, linezolid, daptomycin, and tigecycline and versus Gram-negative bacilli were amikacin, cefepime, doripenem, ertapenem (excluding Pseudomonas aeruginosa), meropenem, piperacillin-tazobactam, and tigecycline (excluding Pseudomonas aeruginosa).
PubMed ID
21353957 View in PubMed
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A case-control study to detect modifiable risk factors for colonization with vancomycin-resistant enterococci.

https://arctichealth.org/en/permalink/ahliterature200128
Source
Infect Control Hosp Epidemiol. 1999 Nov;20(11):760-3
Publication Type
Article
Date
Nov-1999
Author
M. Loeb
S. Salama
M. Armstrong-Evans
G. Capretta
J. Olde
Author Affiliation
Department of Laboratory Medicine, Hamilton Health Sciences Corporation and McMaster University, Ontario, Canada.
Source
Infect Control Hosp Epidemiol. 1999 Nov;20(11):760-3
Date
Nov-1999
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Case-Control Studies
Cross Infection - epidemiology - microbiology
Disease Outbreaks
Enterococcus - drug effects - isolation & purification
Female
Humans
Male
Ontario - epidemiology
Risk factors
Vancomycin - therapeutic use
Vancomycin Resistance
Abstract
A case-control study was conducted to determine the modifiable risk factors associated with vancomycin-resistant Enterococcus (VRE) colonization during a hospital outbreak. Cephalosporin use was identified as the only independent risk factor (odds ratio, 13.8; 95% confidence interval, 2.5-76.3; P = .01). Nursing work-load intensity was not associated with VRE colonization in this study.
PubMed ID
10580629 View in PubMed
Less detail

Clustering of polyclonal VanB-type vancomycin-resistant Enterococcus faecium in a low-endemic area was associated with CC17-genogroup strains harbouring transferable vanB2-Tn5382 and pRUM-like repA containing plasmids with axe-txe plasmid addiction systems.

https://arctichealth.org/en/permalink/ahliterature135292
Source
APMIS. 2011 Apr;119(4-5):247-58
Publication Type
Article
Date
Apr-2011
Author
Eva Bjørkeng
Gunlög Rasmussen
Arnfinn Sundsfjord
Lennart Sjöberg
Kristin Hegstad
Bo Söderquist
Author Affiliation
Research Group for Host-Microbe Interactions, Department of Medical Biology, University of Tromsø, Norway.
Source
APMIS. 2011 Apr;119(4-5):247-58
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Bacterial Proteins - genetics
Bacterial Typing Techniques
Base Sequence
Cluster analysis
Conjugation, Genetic
DNA Transposable Elements
DNA, Bacterial - genetics
Electrophoresis, Gel, Pulsed-Field
Endemic Diseases
Enterococcus faecium - classification - drug effects - genetics - isolation & purification
Female
Genes, Bacterial
Gram-Positive Bacterial Infections - drug therapy - epidemiology - microbiology
Humans
Male
Middle Aged
Plasmids - genetics
Sweden - epidemiology
Vancomycin Resistance - genetics
Virulence - genetics
Abstract
VanB-type vancomycin-resistant Enterococcus faecium isolates (n = 17) from 15 patients at the Örebro University hospital in Sweden during a span of 18 months was characterized. All patients had underlying disorders and received broad-spectrum antimicrobial therapy. Pulsed-field gel electrophoresis (PFGE) grouped 14 isolates in three PFGE types and three isolates in unique PFGE patterns. All isolates had multi-locus sequence types [ST17 (n = 5); ST18 (n = 3); ST125 (n = 7); ST262 (n = 1); ST460 (n = 1)] belonging to the successful hospital-adapted clonal complex 17 (CC17), harboured CC17-associated virulence genes, were vanB2-positive and expressed diverse vancomycin minimum inhibitory concentration (MICs; 8 to > 256 mg/L). Isolate 1 had a unique PFGE type and a chromosomal transferable vanB2-Tn5382 element. Interestingly, the other five PFGE types had Tn5382 located on plasmids containing pRUM-like repA and a plasmid addiction system (axe-txe) shown by co-hybridization analysis of PFGE-separated S1-nuclease digested total DNA. The resistance plasmids were mainly of 120-kb and supported intraspecies vanB transfer. Two strains were isolated from patient 6 and we observed a possible transfer of the vanB2-resistance genes from PFGE type III ST460 to a more successful PFGE type I ST125. This latter PFGE type I ST125 became the predominant type afterwards. Our observations support the notion that vanB-type vancomycin-resistant Enterococcus faecium can persist in a low-endemic area through successful clones and plasmids with stability functions in hospital patients with known risk factors.
PubMed ID
21492224 View in PubMed
Less detail

Comparison of community-associated and health care-associated methicillin-resistant Staphylococcus aureus in Canada: results of the CANWARD 2007-2009 study.

https://arctichealth.org/en/permalink/ahliterature136686
Source
Diagn Microbiol Infect Dis. 2011 Mar;69(3):320-5
Publication Type
Article
Date
Mar-2011
Author
Kimberly A Nichol
Heather J Adam
Zafar Hussain
Michael R Mulvey
Melissa McCracken
Laura F Mataseje
Kristjan Thompson
Sara Kost
Philippe R S Lagacé-Wiens
Daryl J Hoban
George G Zhanel
Author Affiliation
Department of Clinical Microbiology, Health Sciences Centre/Diagnostic Services of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada. knichol@hsc.mb.ca
Source
Diagn Microbiol Infect Dis. 2011 Mar;69(3):320-5
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Acetamides - pharmacology
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacterial Toxins - analysis
Canada - epidemiology
Child
Child, Preschool
Community-Acquired Infections - epidemiology - genetics - microbiology
Cross Infection - epidemiology - genetics - microbiology
DNA, Bacterial - genetics
Daptomycin - pharmacology
Drug Resistance, Bacterial - genetics
Exotoxins - analysis
Female
Hospitals
Humans
Infant
Leukocidins - analysis
Male
Methicillin-Resistant Staphylococcus aureus - genetics
Microbial Sensitivity Tests
Middle Aged
Minocycline - analogs & derivatives - pharmacology
Oxazolidinones - pharmacology
Staphylococcal Infections - epidemiology - microbiology
Vancomycin Resistance
Abstract
This study assessed the demographics, antimicrobial susceptibility, and molecular epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and health care-associated MRSA (HA-MRSA) in Canadian hospitals between 2007 and 2009. Among 3589 S. aureus, 889 (24.8%) were MRSA; 224 (25.2%) were CA-MRSA genotypes and 644 (72.4%) were HA-MRSA genotypes. The prevalence of CA-MRSA genotypes increased from 19.5% in 2007 to 31.9% in 2009 (P
PubMed ID
21353960 View in PubMed
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A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: pre- and post-severe acute respiratory syndrome.

https://arctichealth.org/en/permalink/ahliterature154889
Source
Am J Infect Control. 2008 Dec;36(10):711-7
Publication Type
Article
Date
Dec-2008
Author
Dick E Zoutman
B Douglas Ford
Author Affiliation
Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada. zoutmand@kgh.kari.net
Source
Am J Infect Control. 2008 Dec;36(10):711-7
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Bed Occupancy - statistics & numerical data
Canada - epidemiology
Clostridium difficile
Cross Infection - epidemiology
Data Collection
Enterococcus
Health Resources - organization & administration
Hospital Bed Capacity - statistics & numerical data
Hospitals - statistics & numerical data
Humans
Infection Control - methods - organization & administration
Infection Control Practitioners - organization & administration - statistics & numerical data
Logistic Models
Methicillin-Resistant Staphylococcus aureus
Population Surveillance
Severe Acute Respiratory Syndrome - epidemiology
Staphylococcal Infections - epidemiology
Vancomycin Resistance
Abstract
The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.
In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds. We used chi(2), analysis of variance, and analysis of covariance analyses to test for differences between the 1999 and 2005 samples for infection control program components and ARO rates.
72.3% of Canadian acute care hospitals completed the RICH survey for 1999 and 60.1% for 2005. Hospital size was controlled for in analyses involving AROs and surveillance and control intensity levels. Methicillin-resistant Staphylococcus aureus (MRSA) rates increased from 1999 to 2005 (F = 9.4, P = .003). In 2005, the mean MRSA rate was 5.2 (standard deviation [SD], 6.1) per 1000 admissions, and, in 1999, it was 2.0 (SD, 2.9). Clostridium difficile-associated diarrhea rates trended up from 1999 to 2005 (F = 2.9, P = .09). In 2005, the mean Clostridium difficile-associated diarrhea rate was 4.7 (SD, 4.3), and, in 1999, it was 3.8 (SD, 4.3). The proportion of hospitals that reported having new nosocomial vancomycin-resistant Enterococcus (VRE) cases was greater in 2005 than in 1999 (chi(2) = 10.5, P = .001). In 1999, 34.5% (40/116) of hospitals reported having new nosocomial VRE cases, and, in 2005, 61.0% (64/105) reported new cases. Surveillance intensity index scores increased from a mean of 61.7 (SD, 18.5) in 1999 to 68.1 (SD, 15.4) in 2005 (F = 4.1, P = .04). Control intensity index scores trended upward slightly from a mean of 60.8 (SD, 14.6) in 1999 to 64.1 (SD, 12.2) in 2005 (F = 3.2, P = .07). Infection control professionals (ICP) full-time equivalents (FTEs) per 100 beds increased from a mean of 0.5 (SD, 0.2) in 1999 to 0.8 (SD, 0.3) in 2005 (F = 90.8, P
Notes
ReprintIn: Can J Infect Control. 2009 Summer;24(2):109-1519697536
PubMed ID
18834747 View in PubMed
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A comparison of multifaceted versus Clostridium difficile-focused VRE surveillance strategies in a low-prevalence setting.

https://arctichealth.org/en/permalink/ahliterature194531
Source
Infect Control Hosp Epidemiol. 2001 Apr;22(4):219-21
Publication Type
Article
Date
Apr-2001
Author
K C Katz
M A Gardam
J. Burt
J M Conly
Author Affiliation
Department of Medicine, University Health Network, University of Toronto, Ontario, Canada.
Source
Infect Control Hosp Epidemiol. 2001 Apr;22(4):219-21
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Clostridium Infections - diagnosis - epidemiology
Clostridium difficile - drug effects - isolation & purification
Enterotoxins - isolation & purification
Feces - microbiology
Hospitals, University
Humans
Incidence
Infection Control - methods
Ontario
Population Surveillance - methods
Vancomycin Resistance
Abstract
We compared our current screening strategy for vancomycin-resistant Enterococcus (VRE) with a focused strategy that screens all stool samples sent for Clostridium difficile toxin assay but limits rectal swab screening to wards with new VRE cases detected via C. difficile samples. The proposed strategy detects 72.7% of new VRE cases, with substantial cost savings.
PubMed ID
11379713 View in PubMed
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[Control of vancomycin resistant enterococcus and methicillin resistant staphylococcus aureus bacteria gaining every day].

https://arctichealth.org/en/permalink/ahliterature182180
Source
Perspect Infirm. 2003 Sep-Oct;1(1):25-6
Publication Type
Article
Author
Pierre A Pilon
Author Affiliation
L'unité Maladies infectieuses de la Direction de la santé publique de Montréal-Centre et chargé d'enseignement clinique, Département de médecine sociale et préventive, l'Université de Montréal.
Source
Perspect Infirm. 2003 Sep-Oct;1(1):25-6
Language
French
Publication Type
Article
Keywords
Enterococcus
Gram-Positive Bacterial Infections - epidemiology - microbiology - prevention & control
Humans
Infection Control - methods - trends
Methicillin Resistance
Population Surveillance
Quebec - epidemiology
Risk factors
Staphylococcal Infections - epidemiology - microbiology - prevention & control
Staphylococcus aureus
Vancomycin Resistance
PubMed ID
14705334 View in PubMed
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47 records – page 1 of 5.