Publications by authors named "Robin T Odom"
A retrospective cohort study of antibiotic exposure and vancomycin-resistant Enterococcus recolonization.
Infect Control Hosp Epidemiol
April 2019
Objective: In the National Institutes of Health (NIH) Clinical Center, patients colonized or infected with vancomycin-resistant Enterococcus (VRE) are placed in contact isolation until they are deemed "decolonized," defined as having 3 consecutive perirectal swabs negative for VRE. Some decolonized patients later develop recurrent growth of VRE from surveillance or clinical cultures (ie, "recolonized"), although that finding may represent recrudescence or new acquisition of VRE. We describe the dynamics of VRE colonization and infection and their relationship to receipt of antibiotics.
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- - The hospital serves as a significant reservoir for carbapenem-resistant bacteria, with comprehensive sampling revealing high levels of carbapenemase-producing organisms (CPOs) in wastewater and manholes, despite low patient infection rates.
- - Whole-genome sequencing of isolates showed diverse species and plasmids, indicating both shared and unique genetic traits between environmental and patient populations, representing a possible source for the spread of resistance genes.
- - While most findings suggested effective infection control practices, a likely case of transmission from the cleaning environment to a patient emphasizes the ongoing need for enhanced monitoring and control strategies in hospitals to combat CPOs.
Background: Multidrug-resistant Acinetobacter baumannii (MDRAB) is difficult to treat and eradicate. Several reports describe isolation and environmental cleaning strategies that controlled hospital MDRAB outbreaks. Such interventions were insufficient to interrupt MDRAB transmission in 2 intensive care unit-based outbreaks in our hospital.
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