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Epidemiology and Control of an Outbreak of Vancomycin-Resistant Enterococci in the Intensive Care Units
Yonsei Medical Journal ; : 637-643, 2009.
Article in English | WPRIM | ID: wpr-30697
ABSTRACT

PURPOSE:

This study was aimed to describe a vancomycin-resistant enterococci (VRE) outbreak across three intensive care units (ICUs) of a Korean hospital from September 2006 to January 2007 and the subsequent control strategies. MATERIALS AND

METHODS:

We simultaneously implemented multifaceted interventions to control the outbreak, including establishing a VRE cohort ward, active rectal surveillance cultures, daily extensive cleaning of environmental surfaces and environmental cultures, antibiotic restriction, and education of hospital staff. We measured weekly VRE prevalence and rectal acquisition rates and characterized the VRE isolates by polymerase chain reaction (PCR) of the vanA gene and Sma1-pulsed-field gel electrophoresis (PFGE).

RESULTS:

During the outbreak, a total of 50 patients infected with VRE were identified by clinical and surveillance cultures, and 46 had vancomycin-resistant Enterococcus faecium (VREF). PFGE analysis of VREF isolates from initial two months disclosed 6 types and clusters of two major types. The outbreak was terminated 5 months after implementation of the

interventions:

The weekly prevalence rate decreased from 9.1/100 patients-day in September 2006 to 0.6/100 by the end of January 2007, and the rectal acquisition rates also dropped from 6.9/100 to 0/100 patients-day.

CONCLUSION:

Our study suggests that an aggressive multifaceted control strategy is a rapid, effective approach for controlling a VRE outbreak.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Patient Isolation / Decontamination / Prevalence / Disease Outbreaks / Gram-Positive Bacterial Infections / Enterococcus faecium / Vancomycin Resistance / Intensive Care Units Type of study: Prevalence study / Screening study Limits: Humans Language: English Journal: Yonsei Medical Journal Year: 2009 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Patient Isolation / Decontamination / Prevalence / Disease Outbreaks / Gram-Positive Bacterial Infections / Enterococcus faecium / Vancomycin Resistance / Intensive Care Units Type of study: Prevalence study / Screening study Limits: Humans Language: English Journal: Yonsei Medical Journal Year: 2009 Type: Article