Demographic data of VRE colonized

Demographic data of VRE colonized useful site patients were summarized in Table 3.Figure 1The number of VRE colonized patients between March 2010 and March 2011. Table 2Monthly VRE-colonized and the total number of inpatients.Table 3Demographic data of VRE colonized patients, n (%).In the rectal swab cultures, there were 21 cases with Enterococcus faecium, 7 with E. faecalis, 4 with E. gallinarum, and 2 with E. casseliflavus. VanA resistance was detected in the isolated VRE strains by Polymerase Chain Reaction (PCR).Among the samples obtained from the patient rooms, VRE were detected in two sample cultures that were obtained from the door handle surface of the patient room and from the surface of the shared phone in the room.On the developed form, ��Scoring Form for Fight against VRE,�� the total score for the first week was 72 out of 136.

Significant discrepancies due to implementation mistakes were observed especially in the items pertaining to use of gloves and hand disinfection, the use of gowns, daily patient room cleanliness, terminal disinfection/cleaning (after discharge), and cleaning and disinfection of the materials used for the VRE positive patients. To overcome these discrepancies, HICC offered trainings to health service providers, assistants, faculty members, and patient relatives. In the following weeks, the total scores were added up to 86, 94, 102, 108, 116, 124, 130, and 136; and the colonization was under control within two months.4. DiscussionThe first guideline for controlling VRE within hospitals was published in 1994 by HICPAC [4].

HICPAC included suggestions to decrease transmission among the inpatients at the hospitals. These precautions included limiting Vancomycin use, health personnel trainings on hand hygiene, routine scanning for vancomycin resistance among clinical isolates, and putting VRE positive patients under close contact isolation. Society for Healthcare Epidemiology of America (SHEA) emphasized adding routine active surveillance cultures to these suggestions [6].Despite all these suggestions, studies and the time since, VRE are still an endemic at hospitals with an increasing incidence around the world. Excessive use of antibiotics, use of insensitive methods in stool VRE detection, VRE carriers frequently becoming inpatients at hospitals as transmission sources, and failure to fully comply with infection control methods are among the reasons for this condition [3].

Especially in developing countries with limited resources, factors such as delays in VRE colonization detection, uncontrolled admissions, excessive use of wide spectrum antibiotics, and AV-951 noncompliance with infection control methods make it difficult to fight against VRE [7]. All of these infection control methods, when applied correctly, decrease the frequency of VRE colonization and infection.

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