{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:47:25Z","timestamp":1747172845064,"version":"3.40.5"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:00:00Z","timestamp":1602720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20012180_as1\"><jats:title>Objective:<\/jats:title><jats:p>To evaluate whether vanA rectal screening for vancomycin-resistant <jats:italic>Enterococcus<\/jats:italic> (VRE) predicts vancomycin resistance for patients with enterococcal bloodstream infection (BSI).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012180_as2\"><jats:title>Design:<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012180_as3\"><jats:title>Setting:<\/jats:title><jats:p>Large academic medical center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012180_as4\"><jats:title>Methods:<\/jats:title><jats:p>The predictive performance of a vanA rectal swab was evaluated in 161 critically ill adults with an enterococcal BSI from January 1, 2007, to September 1, 2014, and who had a vanA rectal swab screening obtained within 14 days prior to blood culture.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012180_as5\"><jats:title>Results:<\/jats:title><jats:p>Of the patients meeting inclusion criteria, 83 (51.6%) were vanA swab positive. Rectal-swab\u2013positive patients were more likely to be younger, to be immunocompromised, to have an indwelling central vascular catheter, and to have a history of MDR bacteria. The vanA rectal swab had sensitivity and negative predictive values of 83.6% and 85.9%, respectively, and specificity and positive predictive values of 71.3% and 67.5%, respectively, for predicting a vancomycin-resistant enterococcal BSI in critically ill adults.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012180_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>VanA rectal swabs may be useful for antimicrobial stewardship at institutions with VRE screening already in place for infection control purposes. A higher PPV would be warranted to implement a universal vanA screen on all ICU patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.1218","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T06:32:09Z","timestamp":1602743529000},"page":"411-416","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["VanA rectal swab screening as a predictor of subsequent vancomycin-resistant enterococcal bloodstream infection in critically ill adults"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5532-0384","authenticated-orcid":false,"given":"Shawn J.","family":"Kram","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0779-9113","authenticated-orcid":false,"given":"Bridgette L.","family":"Kram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer M.","family":"Schultheis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Kuhrt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S.","family":"McRae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deverick J.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"S0899823X20012180_ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.14.1754"},{"key":"S0899823X20012180_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/502213"},{"key":"S0899823X20012180_ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000373"},{"key":"S0899823X20012180_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000203"},{"key":"S0899823X20012180_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.380"},{"key":"S0899823X20012180_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"S0899823X20012180_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.150"},{"key":"S0899823X20012180_ref9","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1097\/CCM.0b013e3181eeda3f","article-title":"Methicillin-resistant Staphylococcus aureus nasal colonization is a poor predictor of intensive care unit-acquired methicillin-resistant S aureus infections requiring antibiotic treatment","volume":"38","author":"Sarikonda","year":"2010","journal-title":"Crit Care Med"},{"key":"S0899823X20012180_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(99)00136-4"},{"key":"S0899823X20012180_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.296"},{"key":"S0899823X20012180_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt525"},{"key":"S0899823X20012180_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw246"},{"key":"S0899823X20012180_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw110"},{"key":"S0899823X20012180_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy344"},{"key":"S0899823X20012180_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.156"},{"key":"S0899823X20012180_ref13","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20170034"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20012180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T14:34:08Z","timestamp":1618583648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20012180\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,15]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["S0899823X20012180"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.1218","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"type":"print","value":"0899-823X"},{"type":"electronic","value":"1559-6834"}],"subject":[],"published":{"date-parts":[[2020,10,15]]},"assertion":[{"value":"\u00a9 The Author(s), 2020. 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