Monday, August 30, 2010

Not all patients with VRE need to be isolated

Findings recently published in Clinical Infectious Diseases indicate that not all strains of VRE require contact isolation, which might be seen as counterintuitive.  However, Sutter et al. looked at records for a 9-year period from a bone marrow transplant unit where contact isolation was not required for patients with VRE of genotype vanC – only for vanA and vanB. 

All patients in the bone marrow transplant unit had routine rectal VRE screening and genotyping.  Sutter et al’s goal was to estimate the risk of blood stream infections (BSIs) in patients colonized with VRE vanC.  During the years from January 2008 to July 2008, only one case of BSI was detected, while 290 isolates of VRE vanC were obtained from 273 patients.  This means that only 0.4% of the patients who had VREvanC developed a BSI, despite there being no contact isolation precautions in place.

Sutter et al. conclude that the study provides strong evidence that carriers of VRE vanC do not require contact isolation.  If there isn’t a high prevalence of VRE vanC in your hospital, this might not be as useful, but if genotyping is done and vanC is detected, the hospital does not need to spend resources on contact isolation, and patient care is improved. 

Article here:

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