title: Utility of a focused vancomycin-resistant enterococci screening protocol to identify colonization in hospitalized children.
abstract: Screening for vancomycin-resistant enterococci (VRE) is controversial, and disagreement exists on policy implementation. This study investigated the likelihood of a positive test using 1, 2, or 3 rectal screenings for VRE colonization. In this descriptive study of positive VRE screening cultures, a total of 1211 VRE screens identified 41 positive results. The mean age of these positive patients was 5.7 years. Thirty-nine of the 41 had a chronic illness, and only 2 were healthy. Diagnoses included pulmonary disease in 11 patients and chronic gastrointestinal abnormality in 7. Six patients had been born preterm, and 12 had been treated in a neonatal intensive care unit within the previous 6 months. Thirty-six of the 41 positive results were identified on the first screen. The likelihood of subsequently having a positive screen after a negative screen was 0.43% (95% confidence interval, 0.15%-1.02%). The cost of cultures plus isolation was $50,000 for the study period. Our data show that the likelihood of detecting a positive VRE culture after an initial negative was low, particularly in otherwise healthy children.
authors.affiliation: Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA. gweddle@cmh.edu
authors.forename: Gina
authors.initials: G
authors.lastname: Weddle
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Jackson
authors.forename: Rangaraj
authors.initials: R
authors.lastname: Selvarangan
mesh_terms: D001431:Bacteriological Techniques / Q000191:economics / Q000379:methods; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D003365:Costs and Cost Analysis; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D020713:Vancomycin Resistance