BACKGROUND: The prevalence of vancomycin-resistant enterococci (VRE) is increasing, despite infection control measures. Limited data link ticarcillin-clavulanate to higher VRE prevalence. METHODS: Active surveillance for VRE was conducted before and after a formulary switch from ticarcillin-clavulanate to piperacillin-tazobactam. Rectal swabs were obtained serially in 863 adult patients admitted to intensive care units (ICUs) between November 1, 2000 and September 30, 2004. RESULTS: In the postswitch period, 38 of 497 (7.6%) patients acquired VRE versus 42 of 366 (11.5%) patients in the preswitch period. Survival analysis showed an overall hazard ratio (HR) of .68 postswitch versus preswitch ( P = .07), with the greatest change in the surgical ICU (HR = .17, P = .006). Multivariate analysis showed an overall HR = .51 ( P = .004). Hospital-wide, nonstool VRE clinical cultures fell from 39 (.58/1000 patient days) in the 10-month preswitch period to 27 (.33/1000 patient days) in the 12-month postswitch period. Infection control practices and use of other antibiotics remained stable. CONCLUSIONS: VRE acquisition appeared to decrease in association with a formulary change from ticarcillin-clavulanate to piperacillin-tazobactam.
BACKGROUND: The prevalence of vancomycin-resistant enterococci (VRE) is increasing, despite infection control measures. Limited data link ticarcillin-clavulanate to higher VRE prevalence. METHODS: Active surveillance for VRE was conducted before and after a formulary switch from ticarcillin-clavulanate to piperacillin-tazobactam. Rectal swabs were obtained serially in 863 adult patients admitted to intensive care units (ICUs) between November 1, 2000 and September 30, 2004. RESULTS: In the postswitch period, 38 of 497 (7.6%) patients acquired VRE versus 42 of 366 (11.5%) patients in the preswitch period. Survival analysis showed an overall hazard ratio (HR) of .68 postswitch versus preswitch ( P = .07), with the greatest change in the surgical ICU (HR = .17, P = .006). Multivariate analysis showed an overall HR = .51 ( P = .004). Hospital-wide, nonstool VRE clinical cultures fell from 39 (.58/1000 patient days) in the 10-month preswitch period to 27 (.33/1000 patient days) in the 12-month postswitch period. Infection control practices and use of other antibiotics remained stable. CONCLUSIONS: VRE acquisition appeared to decrease in association with a formulary change from ticarcillin-clavulanate to piperacillin-tazobactam.
Authors: James A McKinnell; Danielle F Kunz; Eric Chamot; Mukesh Patel; Rhett M Shirley; Stephen A Moser; John W Baddley; Peter G Pappas; Loren G Miller Journal: Infect Control Hosp Epidemiol Date: 2012-05-14 Impact factor: 3.254
Authors: Adebola O Ajao; Anthony D Harris; Mary-Claire Roghmann; J Kristie Johnson; Min Zhan; Jessina C McGregor; Jon P Furuno Journal: Infect Control Hosp Epidemiol Date: 2011-05 Impact factor: 3.254
Authors: Rishi Chanderraj; Jess A Millar; Twisha S Patel; Andrew F Read; Laraine Washer; Keith S Kaye; Robert J Woods Journal: Open Forum Infect Dis Date: 2019-03-15 Impact factor: 3.835
Authors: A Simon; T Lehrnbecher; U Bode; A H Groll; L Tramsen; R Wieland; E Molitor; G Fleischhack; H J Laws Journal: Eur J Clin Microbiol Infect Dis Date: 2007-11 Impact factor: 5.103