Substantial resources are used in hospitals worldwide to counteract the ever-increasing incidence of vancomycin-resistant and vancomycin-variable (VREfm and VVEfm), but it is important to balance patient safety, infection prevention, and hospital costs. To investigate the impact of ending VREfm/VVEfm screening and isolation at Odense University Hospital (OUH), Denmark, on patient and clinical characteristics, risk of bacteraemia, and mortality of VREfm/VVEfm disease at OUH. The burden of VREfm/VVEfm bacteraemia at OUH and the three collaborative hospitals in the Region of Southern Denmark (RSD) was also investigated. A retrospective cohort study was conducted including first-time VREfm/VVEfm clinical isolates (index isolates) detected at OUH and collaborative hospitals in the period 2015–2022. The intervention period with screening and isolation was from 2015 to 2021, and the post-intervention period was 2022. Information about clinical isolates was retrieved from microbiological databases. Patient data were obtained from hospital records. At OUH, 436 patients were included in the study, with 285 in the intervention period and 151 in the post-intervention period. Ending screening and isolation was followed by an increased number of index isolates. Besides a change in genes, only minor non-significant changes were detected in all the other investigated parameters. Mortality within 30 days did not reflect the VREfm/VVEfm-attributable deaths, and in only four cases was VREfm/VVEfm infection the likely cause of death. Despite an increasing number of index isolates, nothing in the short follow-up period supported a reintroduction of screening and isolation.

中文翻译：

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耐万古霉素屎肠球菌：丹麦大学医院结束筛查和隔离的影响

世界各地的医院使用大量资源来应对不断增加的万古霉素耐药性和万古霉素变异（VREfm 和 VVEfm）发生率，但平衡患者安全、感染预防和医院费用也很重要。旨在调查丹麦欧登塞大学医院 (OUH) 结束 VREfm/VVEfm 筛查和隔离对 OUH 患者和临床特征、菌血症风险以及 VREfm/VVEfm 疾病死亡率的影响。还对 OUH 和丹麦南部地区 (RSD) 的三家合作医院的 VREfm/VVEfm 菌血症负担进行了调查。进行了一项回顾性队列研究，包括 2015 年至 2022 年期间在 OUH 和合作医院检测到的首次 VREfm/VVEfm 临床分离株（指标分离株）。筛查和隔离的干预期为2015年至2021年，干预后期为2022年。从微生物数据库中检索有关临床分离株的信息。患者数据从医院记录中获得。在 OUH，该研究纳入了 436 名患者，其中 285 名患者处于干预期，151 名患者处于干预后期。筛选和分离结束后，指标分离株数量增加。除了基因的变化之外，在所有其他研究参数中仅检测到微小的非显着变化。 30 天内的死亡率并未反映 VREfm/VVEfm 归因的死亡，并且只有 4 例病例中 VREfm/VVEfm 感染是可能的死亡原因。尽管指示分离株数量不断增加，但在短暂的随访期内没有任何证据支持重新引入筛查和隔离。