Vancomycin-Resistance Enterococci Infections in the Department of the Defense: Annual Report 2014

Abstract : Vancomycin-resistant Enterococci (VRE) are Gram-positive cocci that are resistant to vancomycin and most commonly infect seriously ill patients that have prolonged hospital stays or antibiotic use. Hospital acquired VRE infections are associated with high rates of morbidity and mortality and are a concern for hospitals around the world. The objective of this annual retrospective report is to summarize the VRE infection burden in the Department of Defense (DOD) and the Department of the Navy (DON) for calendar year (CY) 2014. This summary includes demographic and clinical characteristics, antibiotic susceptibility patterns, prescription practices, and healthcare-associated (HA) infection metrics for all DOD and DON beneficiaries. Overall, the incidence rates of VRE infections in the general United States (US) and DOD are decreasing while increasing for the DON populations. VRE risk groups did not substantially change in 2014 as VRE continues to predominately affect elderly females and manifest as urinary tract infections (UTIs). In addition, antibiotic susceptibility patterns did not substantially change in 2014. Daptomycin, linezolid and gentamicin remain viable treatments for VRE. HA infections have decreased in the last year but the overall exposure burden of VRE remains a major problem in the hospital setting. Improved infection control practices would help to minimize the spread of these infections.