Annual Surveillance Summary: Vancomycin-Resistant Enterococci (VRE) Infections in the Military Health System (MHS), 2017
Technical Report,01 Jan 2017,31 Dec 2017
NAVY AND MARINE CORPS PUBLIC HEALTH CENTER PORTSMOUTH VA PORTSMOUTH United States
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The EpiData Center EDC conducts routine surveillance of vancomycin-resistant enterococci VRE incidence and prevalence among all beneficiaries seeking care within the Military Health System MHS. This report describes demographics, clinical characteristics, prescription practices, and antibiotic resistance patterns observed for VRE infections in the calendar year CY 2017. Multiple data sources were linked to assess descriptive and clinical factors related to VRE. Health Level 7 HL7-formatted Composite Health Care System CHCS microbiology data identified Enterococcus species infections resistant to vancomycin. These infections were matched to HL7-formatted CHCS pharmacy data to assess prescription practices, the Standard Inpatient Data Record SIDR to determine healthcare-associated exposures, and the Defense Manpower Data Center DMDC rosters to determine burden among Department of Defense DOD active duty AD service members. Overall, incidence rates IRs of VRE infections declined among MHS beneficiaries to 1.22 per 100,000 persons per year. A slight increase in incidence was observed among Navy beneficiaries however, the IR was within the expected variance with only a 3.7 increase in incident infections. The United States US West and South Atlantic regions had the highest IRs, and healthcare-associated HA cases comprised the largest proportion of all infections identified 82.3 . While the largest proportion of all prevalent infections were classified as community-onset CO 35.4 , a substantial proportion was also identified as hospital-onset HO 28.5 . Treatment for VRE infections among DOD beneficiaries primarily included daptomycin and linezolid, which remained effective through 2017. Current infection control practices appear effective, and continued surveillance is recommended.