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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.
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