Does the removal of isolation for VRE-infected patients change the incidence of health care–associated VRE?: A systematic review and meta-analysis.

Several single-center studies have suggested that eliminating isolation for vancomycin-resistant enterococci (VRE) control in the context of endemic or nonoutbreak settings, has no impact on infection rates. We performed a systematic review and meta-analysis on the impact of discontinuing isolation. We searched PubMed, Embase, the Cochrane Library, and Web of Science through April 10, 2024 for studies evaluating discontinuation of isolation for VRE. Subgroup analyses assessed sources of heterogeneity. Nine studies were included in the final review. Four reported the incidence of hospital-acquired VRE (HA-VRE) infections and 5 reported the incidence of hospital-acquired VRE bloodstream infections (HA-VRE BSI). No significant difference between the rates of HA-VRE infection before and after stopping isolation was observed (risk ratios, 0.93; 95% confidence interval, 0.68-1.26; P =.62), as well as no significant difference on the incidence of HA-VRE BSI (risk ratios, 0.68; 95% confidence interval, 0.44-1.07, P =.09). Furthermore, we conducted 2 subgroup analyses: one stratified by whether the studies were conducted during Coronavirus Disease 19 (COVID-19), and the other stratified by whether clinicians continued to use personal protective equipment. Both analyses revealed no significant differences in the incidence of HA-VRE BSI and termination of isolation between the subgroups. In the context of endemic or nonoutbreak settings, discontinuation of isolation for VRE patients has not been associated with an increased rate of HA-VRE infections. • Examined VRE isolation discontinuation impact in endemic/non-outbreak settings. • Latest evidence on VRE isolation discontinuation. • Discontinuation not linked to higher VRE infections in endemic/non-outbreak. [ABSTRACT FROM AUTHOR]