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J Hosp Infect. 2023;132:1-7.

Impact of discontinuing isolation in a private room for patients infected or colonized with vancomycin-resistant enterococci (VRE) on the incidence of healthcare-associated VRE bacteraemia in a hospital with a predominantly shared-room setting.

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제1저자 장의진, 임다해 · 교신저자 최평균

소속 (4)
  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
  2. Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea.
  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea.
  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: draver@snu.ac.kr.

Abstract

BACKGROUND Isolating patients infected or colonized with vancomycin-resistant enterococci (VRE) in a private room or cohort room to prevent hospital transmission is controversial.

AIM To evaluate the effect of a relaxed isolation policy for VRE-infected or colonized patients on healthcare-associated (HA) VRE bacteraemia in an acute care hospital with a predominantly shared-room setting.

METHODS The incidence of HA VRE bacteraemia was compared during a private isolation era (October 2014-September 2017), a cohort isolation era (October 2017-June 2020), and a no isolation era (July 2020-June 2022). Using Poisson regression modelling, an interrupted time-series analysis was conducted to analyse level changes and trends in incidences of HA VRE bacteraemia for each era.

FINDINGS The proportion of VRE-infected or -colonized patients staying in shared rooms increased from 18.3% in the private isolation era to 82.6% in the no isolation era (P < 0.001). There was no significant difference in the incidences of HA VRE bacteraemia between the private isolation era and the cohort isolation era (relative risk: 1.01; 95% confidence interval: 0.52-1.98; P = 0.977) or between the cohort isolation era and the no isolation era (0.99; 0.77-1.26; P = 0.903). In addition, there was no significant slope increase in the incidence of HA VRE bacteraemia between any of the eras.

CONCLUSION In a hospital with predominantly shared rooms, the relaxation of isolation policy did not result in increased HA VRE bacteraemia, when other infection control measures were maintained.

Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Keywords

Healthcare-associated infectionInfection controlVancomycin-resistant enterococcus

그 밖의 정보
출판 형태
Journal Article
저널
The Journal of hospital infection · eISSN 1532-2939
전자 출판
2022-12-05
MeSH
Humans · Vancomycin-Resistant Enterococci* · Incidence · Cross Infection* / epidemiology / prevention & control · Patients' Rooms · Vancomycin Resistance · Hospitals · Bacteremia* / epidemiology / prevention & control · Gram-Positive Bacterial Infections* / epidemiology / prevention & control