Vancomycin-resistant enterococci in intensive care hospital settings.
Vancomycin-resistant enterococci (VRE) have recently emerged as a nosocomial pathogen and present an increasing threat to the treatment of severely ill patients in intensive-care hospital settings. We outline results of a study of the epidemiology of VRE transmission in ICUs and define a reproductive number R0; the number of secondary colonization cases induced by a single VRE-colonized patient in a VRE-free ICU, for VRE transmission. For VRE to become endemic requires R0 > 1. We estimate that in the absence of infection control measures R0 lies in the range 3-4 in defined ICU settings. Once infection control measures are included R0 = 0.6, suggesting that admission of VRE-colonized patients can stabilize endemic VRE.
Austin
D J
DJ
Wellcome Trust Centre for the Epidemiology of Infectious Diseases, University of Oxford, UK. daren.austin@zoology.oxford.ac.uk
Bonten
M J
MJ
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000635:transmission*; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000635:transmission; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D007362:Intensive Care Units; D014640:Vancomycin / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D014640:Vancomycin