Vancomycin-resistant enterococci: a road map on how to prevent the emergence and transmission of antimicrobial resistance.
Nosocomial acquisition of microorganisms resistant to multiple antibiotics represents a threat to patient safety. Here we review the mechanisms that have allowed highly resistant strains belonging to the Enterococcus genus to proliferate within our health-care institutions. These mechanisms indicate that decreasing the prevalence of resistant organisms requires active surveillance, adherence to vigorous isolation, hand hygiene and environmental decontamination measures, and effective antibiotic stewardship. We suggest how to tailor such a complex, multidisciplinary program to the needs of a particular health-care setting so as to maximize cost-effectiveness.
DeLisle
Sylvain
S
US Veterans Administration Medical Center, Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Maryland, Baltimore 21201, USA. sdelisle@umaryland.edu
Perl
Trish M
TM
D000818:Animals; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control*; D003666:Decontamination; D004197:Disease Reservoirs; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control*; D006235:Hand Disinfection; D006801:Humans; D017053:Infection Control; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D020713:Vancomycin Resistance