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E Queenan

Publications and source records attributed to E Queenan.

3 recordsLinked to original sources

Vancomycin-resistant enterococci: an emerging health problem.

Since 1995, KePRO has worked with the peer review organization for 13 other states/commonwealths and the District of Columbia, as well as the Boston Regional Office of the Health Care Financing Administration, in the implementation of the largest study ever conducted involving Vancomycin-resistant enterococci (VRE). Fifteen Pennsylvania hospitals volunteered to participate in the study, designed to identify and assess the appropriateness of vancomycin use, contributing 19 percent of the total records used in the baseline study. This article, the first of two, describes VRE and its increasing prevalence. In the second installment, we will describe patterns of vancomycin use identified in KePRO's study of participating Pennsylvania hospitals, as well as the steps these hospitals are taking to control antibiotic use. Since all data gathered by KePRO are protected by federal confidentiality guidelines, the facilities that graciously agreed to pioneer KePRO's vancomycin utilization project will not be identified or identifiable.

Anti-Bacterial Agents↗

Vancomycin-resistant enterococci: improving treatments.

Recent issues of Morbidity and Mortality Weekly Report (MMWR), a publication of the Centers for Disease Control and Prevention (CDC), described clinical isolates of Staphylococcus aureus with intermediate resistance to vancomycin in patients in Michigan and New Jersey. As described last month in the first installment of this article, vancomycin has been the only approved antibiotic to which S. aureus had been uniformly sensitive. Media coverage of this latest example of increasing antibiotic resistance included the September 4, 1997, issue of The Wall Street Journal, which carried a report of a large study of the appropriateness of vancomycin use being coordinated by the Health Care Financing Administration (HCFA). The article reported study findings that "63 percent of orders for the drug vancomycin violated guidelines from the Centers for Disease Control and Prevention." In this report, we provide additional details about that study, as well as results specific to the Pennsylvania hospitals that participated in this project. The journal article failed to point out that each of the hospitals volunteered to participate in this 15-state study, beginning in late 1995, as part of their strategy to prevent and control the spread of vancomycin-resistant enterococci (VRE). These facilities agreed with experts that optimizing vancomycin use was an important part of this strategy, in addition to traditional infection control measures such as appropriate handwashing practices, prompt and accurate identification of resistant organisms, and isolation of infected and colonized patients when indicated.

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