Natural history of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus(VRE): a systematic review

Shenoy, Erica S; Paras, Molly L; Noubary, Farzad; Walensky, Rochelle P; Hooper, David C

doi:10.1186/1471-2334-14-177

Table 2 Studies documenting duration of VRE colonization meeting inclusion criteria

From: Natural history of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus(VRE): a systematic review

Author year [ref]	VRE	Study ID	Design	Country	Year of study	Subject description	Screening site	Screening method	Latest documented follow up (weeks)	N	Lost to follow up (N)	Clearance defined	Weeks to documented clearance	% cleared
Montecalvo 1995 [27]	VREF	A	Prospective cohort	USA	1993-4	Hospitalized patients	Perianal	CX; T	18	86	50	1 negative CX on admission and weekly negative culture during admission	18	2%
Brennen 1998 [28]	VREF	B	Prospective cohort	USA	1993-4	Residents in LTCFs	Rectal	CX	25	36	*	2 negative CX on 2 separate samplings	10	50%†
Goetz 1998 [29]	VREF	C	Prospective cohort	USA	1994-6	Hospitalized patients	Rectal or stool	CX	*	210	61	1 negative CX on 2 separate samplings	14	40%†
Bhorade 1999 [30]	ND	D	Prospective cohort	USA	1996-8	Hospitalized patients	Rectal or stool	CX	2	10	6	1 negative CX on 5 separate samplings	N/A	0%
Weinstein 1999 [31]	VREF	E	Prospective cohort	Canada	1995	Hospitalized patients	Rectal	CX	25	24	0	1 negative CX on at least 3 separate samplings	25	38%
D’Agata 2001 [32]	ND	F	Prospective cohort	USA	1998	Hospitalized patients	Rectal	CX	3	13	6	1 negative culture on at least 2 separate samplings	1	8%
Wong 2001 [33]	ND	G	RCT	USA	*	Hospitalized patients and residents of LTCFs	Rectal	CX	3	24	4	1 negative CX on 3 separate samplings	3	21%
Byers 2002 [34]	ND	H	Retrospective cohort	USA	1994-6	Hospitalized patients	Rectal	CX; T	86	116	0	1 negative CX on 3 separate samplings	22	64%
Hachem and Raad 2002 [35]	VREF	I	Prospective cohort	USA	1997	Hospitalized patients	Stool	CX	13	28	0	1 negative CX on at least 2 separate samplings	13	4%
Mascini 2003 [36]	VREF	J	Prospective cohort	Netherlands	2000	Hospitalized patients	Rectal	CX; PCR;T	26	11 (a)	*	3 negative CX on at least 3 separate samplings	6	50%†
Huang 2007 [37]	ND	K1	Retrospective cohort	USA	2002-4	Hospitalized patients	Rectal	CX; PCR (b)	52	394 (c)	*	1 negative CX	9	24%
Huang 2007 [37]	ND	K	Retrospective cohort	USA	2002-4	Hospitalized patients	Rectal	CX; PCR (b)	52	126 (d)	*	1 negative CX	43	84%
Park 2011 [38]	ND	L1	Retrospective cohort	South Korea	2003-10	Hospitalized patients on chronic HD	Rectal	CX	39	89	20	1 negative CX on 3 separate samplings	16	10%
Park 2011 [38]	ND	L	Retrospective cohort	South Korea	2003-10	Hospitalized patients on non-chronic HD	Rectal	CX	35	723	339	1 negative CX on 3 separate samplings	9	12%
Yoon 2011 [39]	VREF	M	Retrospective cohort	South Korea	2006-9	Hospitalized patients	Rectal	CX	19	58	*	1 negative CX on 3 separate samplings	19	28%

(a) Only patients with non-epidemic strain were included in analysis. (b) One of four participating sites used both culture and PCR; the others used culture only. (c) Subset of patients admitted ≤ 60 days from last known positive culture. (d) Subset of patients admitted > 300 days from last known positive culture.
*Not documented; † Kaplan Meier estimates which do not provide information on those lost to follow up.
HCW: health care worker; HD: Hemodialysis; LTCF: long term care facility; VRE: vancomycin resistant enterococcus; VREF: E. faecium; ND: no distinction made between E. faecalis and E faecium; N: number; CX: culture; T; strain typing performed; PCR: polymerase chain reaction; RCT: randomized controlled trial.

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