Vancomycin-resistant enterococci: 15 years and counting

We review the history of vancomycin-resistant enterococci (VRE) and propose a causal model illustrating the roles of exposure to VRE reservoirs, patient characteristics, antimicrobial exposure, and prevalence of VRE in the progression from potential VRE reservoirs to active disease in hospitalized p...

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Bibliographic Details
Published in:	Journal of Hospital Infection Vol. 53; no. 3; pp. 159 - 171
Main Authors:	Chavers, L.S, Moser, S.A, Benjamin, W.H, Banks, S.E, Steinhauer, J.R, Smith, A.M, Johnson, C.N, Funkhouser, E, Chavers, L.P, Stamm, A.M, Waites, K.B
Format:	Book Review Journal Article
Language:	English
Published:	Kent Elsevier Ltd 01-03-2003 Elsevier
Subjects:	Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Carrier State - epidemiology Carrier State - microbiology Carrier State - prevention & control Causality Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - prevention & control Cross Infection - transmission Disease Outbreaks - prevention & control Disease Outbreaks - statistics & numerical data Disease Reservoirs DNA, Bacterial - analysis DNA, Bacterial - genetics Electrophoresis, Gel, Pulsed-Field Enterococcus - classification Enterococcus - genetics Enterococcus - pathogenicity Gram-Positive Bacterial Infections - epidemiology Gram-Positive Bacterial Infections - microbiology Gram-Positive Bacterial Infections - prevention & control Gram-Positive Bacterial Infections - transmission Humans Incidence Medical sciences Pharmacology. Drug treatments Phylogeny Population Surveillance - methods Serotyping Vancomycin Resistance vancomycin, antimicrobials, resistance, enterococci vancomycin, antimicrobials, resistance, enterococci Enterococcus Nosocomial infection Methodology Peptides Transmission Reservoir Review Vancomycin antimicrobials Case history Antimicrobial agent Prevention Resistance Streptococcaceae Antibiotic Surveillance Glycopeptide Risk factor Bacteria Micrococcales Hospital Antibacterial agent enterococci
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Summary:	We review the history of vancomycin-resistant enterococci (VRE) and propose a causal model illustrating the roles of exposure to VRE reservoirs, patient characteristics, antimicrobial exposure, and prevalence of VRE in the progression from potential VRE reservoirs to active disease in hospitalized patients. Differences in VRE colonization and VRE infection are discussed with respect to hospital surveillance methodology and implications for interventions. We further document clonal transmission of VRE in a large, urban, teaching hospital and demonstrate VRE susceptibility to a wide array of antimicrobial agents. This model can guide the identification of mutable factors that are focal points for intervention.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0195-6701 1532-2939
DOI:	10.1053/jhin.2002.1375