Insights into the epidemiology and control of infection with vancomycin-resistant enterococci
Insights into the epidemiology and control of infection with vancomycin-resistant enterococci
复制标题
DOI：
10.1086/318126
复制
发表时间：
2000-10-01
影响因子：
11.8
通讯作者：
Hayden, MK
中科院分区：
文献类型：
--
作者：
Hayden, MK
尽管采取了控制措施，但在美国，由万古霉素耐药肠球菌(VRE)引起的医院感染的发生率仍在继续增加。VRE被认为主要通过交叉污染传播。最近的分子流行病学研究加深了我们对这一现象的理解。如果VRE在进入医院后不久没有得到控制，散发性病例可能会演变为单克隆性暴发，然后可能演变为多克隆性流行。在一种情况下有效地遏制VRE的干预措施在另一种情况下可能无效。在VRE流行的地方，控制VRE尤其具有挑战性。虽然根除地方性VRE可能是不可能的，但积极的、多方面的计划已经成功地减少了这一问题。已报告了VRE传播的数学模型以及感染控制措施在其流行环境中的效果。使用这种模型可以更准确地确定未来控制策略的影响。
Despite control efforts, the incidence of nosocomial infections due to vancomycin-resistant enterococci (VRE) continues to increase in the United States. VRE are thought to spread primarily by cross-contamination. Recent molecular epidemiologic studies have refined our understanding of this phenomenon. If VRE are not controlled soon after introduction into a hospital, sporadic cases may evolve into a monoclonal outbreak, which may then evolve to polyclonal endemicity. An intervention that is effective in containing VRE in one setting may be ineffective in another. Control of VRE where they are endemic is particularly challenging. Although eradication of endemic VRE may not be possible, aggressive, multifaceted programs have been successful in diminishing the problem. A mathematical model of transmission of VRE and the effect of infection control measures in settings where they are endemic has been reported. The use of such a model may allow more precise determination of the impact of control strategies in the future.