Multi-resistant organism colonisation in high-risk patients: a point prevalence study at two large Victorian health services

Jessica Iliffe 1

Infection Prevention Nurse Consultant, The Alfred, Prahran, VIC, Australia


Carbapenemase-producing Enterobacteriaceae (CPE) and vanA strains of vancomycin-resistant Enterococci (VRE vanA) have recently emerged in some Australian healthcare facilities. The antimicrobial susceptibility of these multi-resistant organisms (MROs) means that treatment options for infections are limited. Our objective was to estimate the burden of MROs by determining the prevalence of colonisation with these organisms in high-risk patients at two large Victorian health services.

A prospective survey of high-risk wards was conducted at two multi-campus Victorian health services (Alfred Health, Monash Health). Surveyed wards included ICU, haematology/oncology, colorectal and aged care wards (Alfred Health); nephrology, ICU, and two surgical wards (Monash Health). Consenting patients were asked questions regarding previous hospital admissions and overseas travel in the last 12 months. Two rectal swabs were collected from each participant.

Alfred Health: 129 patients were surveyed. VRE vanA was detected in 8 patients (prevalence 6.2%; 95% CI: 2.91%, 12.25%) and VRE vanB was detected in 24 patients (prevalence 18.6%; 95% CI: 12.51%, 26.62%). Monash Health: 98 patients were surveyed. VRE vanA was detected in 4 patients (prevalence 4.1%; 95% CI: 1.1%, 10.1%) and VRE vanB was detected in 8 patients (prevalence 8.2%; 95% CI: 3.6%, 15.4%). No surveyed patients at either health service were colonised with CPE.

CPE does not currently appear to be present in high-risk patients in the studied health services. While VRE vanB has been endemic for many years, there are a significant proportion of patients (5.3%) in high-risk populations now colonized with VRE vanA.

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