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Vancomycin Resistant Enterococci (VRE) Prediction Rule | Vanco Resistant Enterococcus

Purpose: To identify a patient being admitted to the ICU who should be screened for vancomycin resistant enterococci (VRE) using the rule of Yoon et al.

Description

Yoon et al developed a clinical prediction rule for identifying a patient being admitted to the intensive care unit (ICU) who may be colonized with vancomycin-resistant enterococci (VRE). This can help to identify a patient who should be screened more carefully to prevent spread of the organism. The authors are from Korea University Medical Center in Seoul.


Patient selection: admission to ICU at a university hospital with low VRE prevalence (3-4%)

 

Parameters:

(1) ICU readmission during hospital stay

(2) chronic obstructive lung disease (COLD)

(3) recent therapy with vancomycin

(4) recent therapy with antibiotics

 

Parameter

Finding

Points

ICU readmission

no

0

 

yes

1

COLD

no

0

 

yes

2

recent vancomycin therapy

no

0

 

yes

2

recent antibiotic therapy

no

0

 

yes

3

 

where:

• Chronic obstructive lung disease is associated with readmissions, prolonged hospitalizations, frequent antibiotic therapy and other comorbidities.

• Recent therapy with antibiotics appears to apply to non-vancomycin antibiotics, probably broad-spectrum.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 8 (maximum score seen in study patients was 7).

• A score >= 3 was associated with VRE carriage.

 

Performance:

• The sensitivity was 84% and specificity 83%.

• The negative predictive value was 99% (so good for excluding). The positive predictive value was only 15%.


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Specialty

Objective

ICD-10