Cancer, Vancomycin (Glycopeptide) Resistant Enterococcus (VRE)
Conditions
Brief summary
The study aims to evaluate the impact of contact precautions on the rate of VRE- the rate of colonization and infection aand hospital-acquired VRE transmissions. Hematological and oncological wards in hospitals with a non-outbreak setting for VRE and adhering to at least the following standard of care are eligible for study participation: Fecal screening for the presence of VRE of all patients within 72 hours of each admission by use of a rectal swab or stool sample Follow-up fecal screening once a week and within 72 hours of discharge Implementation of clinical standards aimed at VRE decolonization is not allowed on wards participating in this study, including in the context of clinical studies. Sites will be grouped according to their approach regarding contact isolation (see group description). As a control for external factors a hand hygiene program, including training and adherence assessments, will be implemented. This observational study prospectively compares wards with different approaches to isolation. All screening and isolation measures are already in place on participating wards (i.e. constituted a site selection criterion) and are exclusively implemented as part of the standard of care. Sites are free to adjust their standard of care as they see fit. No intervention will be performed.
Interventions
None listed
Sponsors
German Center for Infection Research
University Hospital Tuebingen
Universitätsklinikum Hamburg-Eppendorf
University Hospital Freiburg
Universitätsklinikum Köln
University of Cologne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Inclusion criteria: * Inpatient hospitalization during the study period on one of the participating wards. *
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of hospital-acquired VRE-colonization and/or infection | 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of VRE intestinal colonization among all patients | 1 year | Colonization is defined as the isolation of VRE from fecal screening samples |
| Incidence of VRE bloodstream infections among all patients | 1 year | VRE bloodstream infection is defined by the isolation of VRE from at least one blood culture |
| Incidence of patient-to-patient transmission of VRE | 1 year | Defined by the isolation of molecularly related VRE strains from patients with overlapping hospitalization periods in the same ward. |
| Readmission fraction associated with VRE infection | 1 year | — |
| Prevalence of VRE in the community. | 1 year | Defined as VRE-colonization upon the first admission of a patient not transferred from another hospital or a long term care facility |
| Incidence of VRE bloodstream infections among previously colonized patients | 1 year | — |
Outcome results
None listed