Isenman Heather, Fisher Dale
aDivision of Infectious Diseases, University Medicine Cluster, National University Hospital, Singapore bYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Curr Opin Infect Dis. 2016 Dec;29(6):577-582. doi: 10.1097/QCO.0000000000000311.
This article reviews data, particularly from the last 2 years, addressing the prevention and treatment of vancomycin-resistant Enterococcus (VRE). We focus on infection control, particularly active screening, use of contact precautions as well as pharmacologic options for therapy. This is timely given the evolving priorities in efforts towards the prevention and treatment of multidrug-resistant organisms globally.
Key findings include new data regarding the impact of contact precautions on the incidence of VRE colonization and bloodstream infection, new laboratory screening methods, and novel decolonization strategies and treatments.
Additional and specific measures beyond standard precautions for infection prevention of VRE remain controversial. Horizontal measures such as chlorhexidine bathing appear beneficial, as are nontouch environmental cleaning methods. Treatment options for invasive disease have improved considerably in the last decade. Decolonization strategies require further research. Overall, the threat of VRE seems exaggerated.
本文回顾相关数据，特别是过去两年的数据，涉及耐万古霉素肠球菌（VRE）的预防和治疗。我们重点关注感染控制，尤其是主动筛查、接触预防措施的使用以及治疗的药物选择。鉴于全球在预防和治疗多重耐药菌方面不断变化的优先事项，这一回顾很及时。
主要发现包括关于接触预防措施对VRE定植和血流感染发生率影响的新数据、新的实验室筛查方法以及新的去定植策略和治疗方法。
除了预防VRE感染的标准预防措施外，额外的具体措施仍存在争议。诸如洗必泰沐浴等横向措施似乎有益，非接触式环境清洁方法也是如此。在过去十年中，侵袭性疾病的治疗选择有了很大改善。去定植策略需要进一步研究。总体而言，VRE的威胁似乎被夸大了。
