At the Johns Hopkins Hospital, we perform surveillance for healthcare-associated transmission of VRE.  The ICUs and other high-risk units perform VRE peri-rectal surveillance cultures upon patient admission to the unit and weekly thereafter.  Healthcare-associated transmission of VRE is defined as definite if the unit admission culture is negative and a subsequent clinical or surveillance culture grows VRE >48 hours after unit admission.  Healthcare-associated transmission is defined as possible, but not definite, if there an admission surveillance culture is not performed and a subsequent clinical or surveillance culture grows VRE >48 hours after unit admission.    VRE healthcare-associated transmission rates are expressed as the number of VRE transmissions per 1000 patient days.  Our VRE transmission prevention program includes hand hygiene promotion, surveillance cultures on high-risk units, isolation precautions, environmental cleaning and disinfection, and programs to promote, monitor and sustain evidence-based best practices for MDRO prevention. 

Tools and Resources

• JHH Hand Hygiene Policy
• JHH Isolation Policy
• HICPAC Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006 
• HICPAC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings