Impact of change in vancomycin-resistant Enterococcus infection prevention policy

To the Editor—Vancomycin-resistant Enterococcus (VRE) is a nosocomial pathogen of clinical importance, given increasing healthcare-associated infection rates since its discovery in 1988 and limited treatment options.1 A widely adopted infection control practice, recommended by the Centers for Disease Control and Prevention (CDC), is active surveillance for colonization of high-risk patients, with isolation and contact precautions for colonized individuals, to reduce transmission, subsequent colonization, and invasive infection with VRE.1 Despite widespread implementation, underlying evidence is conflicting.2 Some studies demonstrate no significant impact on invasive VRE infection rates, despite cessation of single-room isolation and contact precautions.3,4 We evaluated the impact of ceasing active surveillance, single-room isolation, and contact precautions for VRE-colonized patients, as well as change in cleaning procedure, on the rate of invasive VRE infection in our institution. In summary, we performed a retrospective analysis of invasive VRE infection rates over a 6-year period to determine the impact of surveillance and isolation cessation for VRE colonization and change in hospital cleaning procedure. [...]the COVID-19 pandemic coincided with the postintervention period, potentially introducing unmeasured confounding factors.