Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
Department of Neuroanaesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
APMIS. 2022 Nov;130(11):657-660. doi: 10.1111/apm.13263. Epub 2022 Aug 26.
Denmark has experienced an increase in the proportion of invasive vancomycin-resistant Enterococcus faecium (VRE) since 2002 (e.g. <4% in 2015, 7.1% in 2017 and 12% in 2018). At Rigshospitalet, we employ active screening at departments with high prevalence or in case of outbreaks. This includes the collection of rectal swabs specifically for VRE screening. Our purpose was to describe the carrier prevalence of vancomycin-resistant enterococci among acute patients admitted to the Neurointensive Care Unit, Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen, Denmark (NICU). Between April 2018 and January 2019, we investigated 99 consecutive rectal swabs from patients admitted to NICU. The primary outcome was prevalence of VRE carriage. The median age was 64 years (range 23-87) and gender was equally distributed (Female = 47, Male = 46). 26 (28%) had previously been admitted within 179 days and 67 patients (72%) had no hospital admissions within 180 days prior to the admission to NICU. Of the 93 rectal swabs, 2 (2%, 95% CI 0.26-7.55%) were positive for vanA and none were positive for vanB. Routine screening of all patients at admission may be effective in hospital settings with high VRE prevalence, whereas the benefit of screening for VRE in hospitals with a low prevalence may be restricted to specific patient populations.
自 2002 年以来,丹麦侵袭性万古霉素耐药粪肠球菌(VRE)的比例有所增加(例如,2015 年<4%,2017 年 7.1%,2018 年 12%)。在 Rigshospitalet,我们在高流行科室或出现暴发时主动进行筛查。这包括专门收集直肠拭子进行 VRE 筛查。我们的目的是描述丹麦哥本哈根 Rigshospitalet 神经麻醉科神经重症监护病房(NICU)急性入院患者中耐万古霉素肠球菌的携带率。2018 年 4 月至 2019 年 1 月,我们对 99 例连续入住 NICU 的患者进行了直肠拭子调查。主要结局是 VRE 携带率。中位年龄为 64 岁(范围 23-87 岁),性别分布均衡(女性=47 例,男性=46 例)。26 例(28%)患者在 179 天内曾入院,67 例(72%)患者在入住 NICU 前 180 天内无住院史。在 93 例直肠拭子中,有 2 例(2%,95%CI 0.26-7.55%)为 vanA 阳性,均为 vanB 阳性。在 VRE 高流行的医院环境中,对所有入院患者进行常规筛查可能是有效的,而在 VRE 低流行的医院中,对特定患者群体进行筛查的益处可能受到限制。