Impact of a vancomycin-resistant Enterococcus (VRE) screening result on appropriateness of antibiotic therapy.
Antimicrob Steward Healthc Epidemiol
; 1(1): e41, 2021.
Article
en En
| MEDLINE
| ID: mdl-36168474
ABSTRACT
Objective:
Vancomycin-resistant Enterococcus (VRE) infections have been associated with increased mortality and poor outcomes. VRE screening has been used to identify colonized patients to prevent transmission; however, little is known about the utility of screening results to guide antibiotic therapy. Design andsetting:
A retrospective review was performed at a tertiary-care center between June 1, 2015, and May 31, 2018. Patients All patients who underwent VRE polymerase chain reaction assay (PCR) screening and had a bacterial culture from 7 days before to 90 days after the screening test were included. In total, 1,374 patients who had a VRE screening test met inclusion criteria.Methods:
Sensitivity, specificity, and positive and negative predictive values of VRE screening for VRE infection were calculated. The appropriateness of the antibiotic therapy for each patient based on screening results was also assessed.Results:
We detected no difference in the appropriateness of antibiotic therapy between patients with a positive screen and those with a negative screen (59.3% vs 61.0%; P = .8657). The VRE PCR demonstrated 54% sensitivity, 89% specificity, a positive predictive value (PPV) of 13% and a negative predictive value (NPV) of 98%.Conclusions:
The high NPV and specificity indicate that patients with a negative VRE screening results may not require empiric antibiotic coverage for VRE. Although VRE screening may have utility to detect colonization in high-risk patients, a positive VRE screen is of limited value in determining the need for an antibiotic with VRE culture-directed coverage.
Texto completo:
1
Banco de datos:
MEDLINE
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
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Screening_studies
Idioma:
En
Revista:
Antimicrob Steward Healthc Epidemiol
Año:
2021
Tipo del documento:
Article