M. Mulder , K.E.W. Vendrik , S.A.M. van Kessel , D.W. Notermans , A.F. Schoffelen , J. Flipse , A.P.A. Hendrickx , W.C. van der Zwet , C. Schneeberger-van der Linden
{"title":"荷兰医疗机构对耐万古霉素肠球菌的管理：一项全国性调查。","authors":"M. Mulder , K.E.W. Vendrik , S.A.M. van Kessel , D.W. Notermans , A.F. Schoffelen , J. Flipse , A.P.A. Hendrickx , W.C. van der Zwet , C. Schneeberger-van der Linden","doi":"10.1016/j.jhin.2024.09.028","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Vancomycin-resistant <em>Enterococcus faecium</em> (VRE<sub>fm</sub>) is an opportunistic pathogen, which can cause outbreaks in hospitals. In the Netherlands, several national guidelines and guidance documents on different aspects of VRE<sub>fm</sub> management are available. Most available guidelines are written towards the hospital setting and only few on long-term care facilities (LTCFs). Moreover, not all aspects of VRE<sub>fm</sub> management are covered, recommendations differ and the level of compliance to these guidelines is unknown. The aim of this study was to get insight into the routine VRE<sub>fm</sub> policies in Dutch healthcare facilities with regard to screening, diagnostics and infection control measures.</div></div><div><h3>Methods</h3><div>Online questionnaires were sent to representatives of Dutch hospitals and LTCFs. The questionnaire included questions regarding the definition of VRE, screening, diagnostics, patient isolation, cleaning procedures, VRE<sub>fm</sub> clearance and VRE<sub>fm</sub> outbreaks.</div></div><div><h3>Findings</h3><div>The questionnaire was completed by 61 hospitals with a response rate of 84.1% and 57 LTCFs, mostly nursing homes. Most hospitals reported VRE<sub>fm</sub> outbreaks in the previous decade, whereas only one LTCF reported an outbreak. Of the hospitals, 87% perform VRE<sub>fm</sub> screening versus 50% of the LTCFs. VRE<sub>fm</sub>-positive patients are isolated in 98% of hospitals and 83% of LTCFs. Protocols regarding how to unlabel VRE<sub>fm</sub>-positive patients are in place in 84% of the hospitals and in 51% of LTCFs. The details of these measures differ substantially between healthcare facilities.</div></div><div><h3>Conclusion</h3><div>This study has shown that most hospitals and some LTCFs in the Netherlands have standard procedures for VRE<sub>fm</sub> management to some level, although the comprehensiveness and details of the measures differ per hospital. More uniform policies would improve comparability of VRE<sub>fm</sub> data on a regional/national level.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":"Pages 51-59"},"PeriodicalIF":3.9000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of vancomycin-resistant Enterococcus faecium in Dutch healthcare institutes: a nationwide survey\",\"authors\":\"M. Mulder , K.E.W. Vendrik , S.A.M. van Kessel , D.W. Notermans , A.F. Schoffelen , J. Flipse , A.P.A. Hendrickx , W.C. van der Zwet , C. Schneeberger-van der Linden\",\"doi\":\"10.1016/j.jhin.2024.09.028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Vancomycin-resistant <em>Enterococcus faecium</em> (VRE<sub>fm</sub>) is an opportunistic pathogen, which can cause outbreaks in hospitals. In the Netherlands, several national guidelines and guidance documents on different aspects of VRE<sub>fm</sub> management are available. Most available guidelines are written towards the hospital setting and only few on long-term care facilities (LTCFs). Moreover, not all aspects of VRE<sub>fm</sub> management are covered, recommendations differ and the level of compliance to these guidelines is unknown. The aim of this study was to get insight into the routine VRE<sub>fm</sub> policies in Dutch healthcare facilities with regard to screening, diagnostics and infection control measures.</div></div><div><h3>Methods</h3><div>Online questionnaires were sent to representatives of Dutch hospitals and LTCFs. The questionnaire included questions regarding the definition of VRE, screening, diagnostics, patient isolation, cleaning procedures, VRE<sub>fm</sub> clearance and VRE<sub>fm</sub> outbreaks.</div></div><div><h3>Findings</h3><div>The questionnaire was completed by 61 hospitals with a response rate of 84.1% and 57 LTCFs, mostly nursing homes. Most hospitals reported VRE<sub>fm</sub> outbreaks in the previous decade, whereas only one LTCF reported an outbreak. Of the hospitals, 87% perform VRE<sub>fm</sub> screening versus 50% of the LTCFs. VRE<sub>fm</sub>-positive patients are isolated in 98% of hospitals and 83% of LTCFs. Protocols regarding how to unlabel VRE<sub>fm</sub>-positive patients are in place in 84% of the hospitals and in 51% of LTCFs. The details of these measures differ substantially between healthcare facilities.</div></div><div><h3>Conclusion</h3><div>This study has shown that most hospitals and some LTCFs in the Netherlands have standard procedures for VRE<sub>fm</sub> management to some level, although the comprehensiveness and details of the measures differ per hospital. More uniform policies would improve comparability of VRE<sub>fm</sub> data on a regional/national level.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"155 \",\"pages\":\"Pages 51-59\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S019567012400344X\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S019567012400344X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Management of vancomycin-resistant Enterococcus faecium in Dutch healthcare institutes: a nationwide survey
Background
Vancomycin-resistant Enterococcus faecium (VREfm) is an opportunistic pathogen, which can cause outbreaks in hospitals. In the Netherlands, several national guidelines and guidance documents on different aspects of VREfm management are available. Most available guidelines are written towards the hospital setting and only few on long-term care facilities (LTCFs). Moreover, not all aspects of VREfm management are covered, recommendations differ and the level of compliance to these guidelines is unknown. The aim of this study was to get insight into the routine VREfm policies in Dutch healthcare facilities with regard to screening, diagnostics and infection control measures.
Methods
Online questionnaires were sent to representatives of Dutch hospitals and LTCFs. The questionnaire included questions regarding the definition of VRE, screening, diagnostics, patient isolation, cleaning procedures, VREfm clearance and VREfm outbreaks.
Findings
The questionnaire was completed by 61 hospitals with a response rate of 84.1% and 57 LTCFs, mostly nursing homes. Most hospitals reported VREfm outbreaks in the previous decade, whereas only one LTCF reported an outbreak. Of the hospitals, 87% perform VREfm screening versus 50% of the LTCFs. VREfm-positive patients are isolated in 98% of hospitals and 83% of LTCFs. Protocols regarding how to unlabel VREfm-positive patients are in place in 84% of the hospitals and in 51% of LTCFs. The details of these measures differ substantially between healthcare facilities.
Conclusion
This study has shown that most hospitals and some LTCFs in the Netherlands have standard procedures for VREfm management to some level, although the comprehensiveness and details of the measures differ per hospital. More uniform policies would improve comparability of VREfm data on a regional/national level.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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