A coalition comprised of healthcare facilities, state and local health departments in the Siouxland Region of Iowa, Nebraska, and South Dakota, the Indian Health Service, and the Centers for Disease Control and Prevention (CDC) has been successful in combating the spread of vancomycin-resistant enterococcus (VRE), according to data published in the May 10 issue of the New England Journal of Medicine.

VRE, one of the most common bacteria that cause infections in healthcare facilities, was first detected in the Siouxland Region in late 1996; within 6 months, VRE had quickly spread to nearly 50 percent of the healthcare facilities in the region. A VRE Task Force comprised of representatives from acute and long-term care facilities and public health departments in the region was soon formed to help implement, expand and individualize CDC’s recommendations to control VRE in healthcare facilities. The guidelines call for detecting VRE-colonized or infected patients, implementing appropriate infection control measures, and improving the use of antibiotics. The VRE Taskforce implemented a comprehensive intervention program–including aggressive culturing of patients to identify VRE-colonized patients, isolation of patients, and improved healthcare worker hand hygiene. In two years, VRE was significantly reduced in all healthcare facilities in the Siouxland region; this included a marked reduction in long-term care facilities and elimination in all acute care facilities. Healthcare facilities in the coalition continue to monitor for the presence of VRE.

"This study demonstrates that collaborations that include infection control professionals, clinicians, and local/state/federal health agencies can succeed in preventing infections and promoting patient safety across the whole delivery system," said Dr. Julie Gerberding, director of CDC’s Division of Healthcare Quality Promotion (DHQP). "Applying the lessons learned from this project to other states has the potential to dramatically reduce resistant infections and protect patients."

Over the past decade, VRE has rapidly emerged as a healthcare-associated pathogen in U.S. hospitals; many outbreaks have occurred and VRE has become endemic in many facilities. Many facilities around the United States are working to implement CDC’s guidelines to prevent the spread of VRE in healthcare facilities. In fact, there have been several reports of VRE being controlled on one ward or in one healthcare facility. However, this intervention project represents the first time that a large coalition of healthcare facilities in a region and state and local health departments have worked together to address this emerging infection..

"This unique partnership of healthcare facilities, local, state and federal public health departments has been effective because of the willingness of the participants to work together to control this important antimicrobial-resistant pathogen. This organism is easily spread from one healthcare institution to another which can make it difficult to address without a collaborative effort," said Dr. Bill Jarvis, DHQP.

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