PMID- 37351725
OWN - NLM
STAT- MEDLINE
DCOM- 20230717
LR  - 20230718
IS  - 1435-4373 (Electronic)
IS  - 0934-9723 (Print)
IS  - 0934-9723 (Linking)
VI  - 42
IP  - 8
DP  - 2023 Aug
TI  - Contact tracing for vancomycin-resistant Enterococcus faecium (VRE): evaluation 
      of the Dutch policy of quintuple screening cultures.
PG  - 993-999
LID - 10.1007/s10096-023-04632-7 [doi]
AB  - Detection of vancomycin-resistant Enterococcus faecium (VRE) is hampered by low 
      sensitivity of rectal swab cultures. This study aimed to define the number of 
      screening cultures needed to increase sensitivity to detect VRE transmission, and 
      to determine time from presumed exposure to detectable colonization. In a 
      tertiary care setting, we retrospectively analyzed data from 9 VRE outbreaks. As 
      a proxy or estimation for time to detectable colonization, the time between first 
      positive culture of the presumed index patient and that of their contacts was 
      determined. Only 64% of secondary cases were positive in the first out of five 
      cultures. By using the first three out of five rectal swabs, 89% (95%CI: 78-95%) 
      of all secondary cases would have been identified. The median number of days 
      between the positive culture of the index patient and the first positive culture 
      of secondary cases was 9 days. Eleven percent of secondary cases would have been 
      missed if only three rectal samples would have been obtained. Furthermore, our 
      results show that one or more rectal swabs taken around day 9 after presumed 
      exposure should at least be included in the screening approach. In our setting, 
      obtaining a fourth and a fifth rectal swab showed a relevant additional value 
      compared to only one to three swabs. Our findings are useful for determining the 
      most effective VRE contact tracing approach to prevent transmission.
CI  - (c) 2023. The Author(s).
FAU - Wammes, Linda J
AU  - Wammes LJ
AUID- ORCID: 0000-0002-6660-9738
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
AD  - Present address: Department of Medical Microbiology, LUMC Center for Infectious 
      Diseases, Leiden University Medical Center, Leiden, The Netherlands.
FAU - Voor In 't Holt, Anne F
AU  - Voor In 't Holt AF
AUID- ORCID: 0000-0002-3560-1725
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
FAU - Klaassen, Corne H W
AU  - Klaassen CHW
AUID- ORCID: 0000-0002-3439-0903
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
FAU - Vos, Margreet C
AU  - Vos MC
AUID- ORCID: 0000-0002-0496-7038
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
FAU - Verkaik, Nelianne J
AU  - Verkaik NJ
AUID- ORCID: 0000-0003-2351-2669
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
FAU - Severin, Juliette A
AU  - Severin JA
AUID- ORCID: 0000-0002-5222-3017
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. 
      j.severin@erasmusmc.nl.
LA  - eng
PT  - Journal Article
DEP - 20230623
PL  - Germany
TA  - Eur J Clin Microbiol Infect Dis
JT  - European journal of clinical microbiology & infectious diseases : official 
      publication of the European Society of Clinical Microbiology
JID - 8804297
RN  - 6Q205EH1VU (Vancomycin)
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Humans
MH  - Vancomycin
MH  - *Enterococcus faecium
MH  - Contact Tracing
MH  - Retrospective Studies
MH  - *Vancomycin-Resistant Enterococci
MH  - *Gram-Positive Bacterial Infections/diagnosis/epidemiology/microbiology
MH  - Anti-Bacterial Agents/therapeutic use
PMC - PMC10345005
OTO - NOTNLM
OT  - Contact tracing
OT  - Enterococcus faecium
OT  - Infection control
OT  - Outbreaks
OT  - Policy
OT  - Vancomycin resistance
COIS- The authors declare no competing interests.
EDAT- 2023/06/23 13:07
MHDA- 2023/07/17 06:42
PMCR- 2023/06/23
CRDT- 2023/06/23 11:11
PHST- 2023/02/11 00:00 [received]
PHST- 2023/06/07 00:00 [accepted]
PHST- 2023/07/17 06:42 [medline]
PHST- 2023/06/23 13:07 [pubmed]
PHST- 2023/06/23 11:11 [entrez]
PHST- 2023/06/23 00:00 [pmc-release]
AID - 10.1007/s10096-023-04632-7 [pii]
AID - 4632 [pii]
AID - 10.1007/s10096-023-04632-7 [doi]
PST - ppublish
SO  - Eur J Clin Microbiol Infect Dis. 2023 Aug;42(8):993-999. doi: 
      10.1007/s10096-023-04632-7. Epub 2023 Jun 23.