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Antibiotics
Volume 14
Issue 3
10.3390/antibiotics14030304
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Article

Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting

by
Assunta Navarra
1,
Stefania Cicalini
2,*,
Silvia D’Arezzo
3,
Francesca Pica
4,
Marina Selleri
3,
Carla Nisii
3,
Carolina Venditti
3,
Angela Cannas
3,
Antonio Mazzarelli
3,
Antonella Vulcano
3,
Stefania Carrara
3,
Donatella Vincenti
3,
Barbara Bartolini
3,
Paolo Giacomini
5,
Maria Grazia Bocci
6,† and
Carla Fontana
3,†
1
Clinical Epidemiology Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy
2
Systemic and Immune Depression-Associated Infections Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy
3
Microbiology and Biobank Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy
4
Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
5
Health Direction, Hospital Information Service, National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy
6
Intensive Care Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Antibiotics 2025, 14(3), 304; https://doi.org/10.3390/antibiotics14030304
Submission received: 27 January 2025 / Revised: 8 March 2025 / Accepted: 11 March 2025 / Published: 16 March 2025
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Abstract

Background: Vancomycin-resistant enterococci (VRE) rectal colonization represents a critical risk factor for subsequent bloodstream infections (BSIs), posing a serious concern in healthcare settings. This study aims to investigate the association between the presence of VRE in rectal swabs and the occurrence of BSIs, highlighting the challenges of rapid detection and patient care implications in an infectious disease hospital setting. Methods: We performed a retrospective analysis of cultural rectal swab screening and molecular assays (MAs) for VRE detection between January 2020 and December 2023. All adult patients admitted with at least one rectal swab screening performed during hospitalization were included. All blood cultures that yielded VRE were identified, and the first Enterococcus-positive blood sample for each patient with at least one prior rectal swab per year was analyzed. Results: The results showed a 15.4% positivity rate for VRE in cultural screening, predominantly Enterococcus faecium. MA showed a higher prevalence of 49.4%, with a significant discordance between MA rectal swab screening and cultural testing. Patients with VRE intestinal colonization by E. faecium were significantly more likely to develop E. faecium BSI, with a risk ratio of 9.78 (p < 0.001). Conclusions: The study identified a strong correlation between VRE rectal colonization and the risk of developing BSI, emphasizing the need for effective screening and infection control measures. The results support the inclusion of molecular testing in VRE detection protocols and highlight the importance of ongoing surveillance for antimicrobial resistance.
Keywords: vancomycin-resistant enterococci (VRE); cultural tests; molecular tests; bloodstream infections (BSIs); antimicrobial surveillance protocols vancomycin-resistant enterococci (VRE); cultural tests; molecular tests; bloodstream infections (BSIs); antimicrobial surveillance protocols

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MDPI and ACS Style

Navarra, A.; Cicalini, S.; D’Arezzo, S.; Pica, F.; Selleri, M.; Nisii, C.; Venditti, C.; Cannas, A.; Mazzarelli, A.; Vulcano, A.; et al. Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting. Antibiotics 2025, 14, 304. https://doi.org/10.3390/antibiotics14030304

AMA Style

Navarra A, Cicalini S, D’Arezzo S, Pica F, Selleri M, Nisii C, Venditti C, Cannas A, Mazzarelli A, Vulcano A, et al. Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting. Antibiotics. 2025; 14(3):304. https://doi.org/10.3390/antibiotics14030304

Chicago/Turabian Style

Navarra, Assunta, Stefania Cicalini, Silvia D’Arezzo, Francesca Pica, Marina Selleri, Carla Nisii, Carolina Venditti, Angela Cannas, Antonio Mazzarelli, Antonella Vulcano, and et al. 2025. "Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting" Antibiotics 14, no. 3: 304. https://doi.org/10.3390/antibiotics14030304

APA Style

Navarra, A., Cicalini, S., D’Arezzo, S., Pica, F., Selleri, M., Nisii, C., Venditti, C., Cannas, A., Mazzarelli, A., Vulcano, A., Carrara, S., Vincenti, D., Bartolini, B., Giacomini, P., Bocci, M. G., & Fontana, C. (2025). Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting. Antibiotics, 14(3), 304. https://doi.org/10.3390/antibiotics14030304

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