Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention
Braz. j. med. biol. res
; 45(2): 158-162, Feb. 2012. ilus, tab
Article
in English
| LILACS
| ID: lil-614578
Responsible library:
BR1.1
ABSTRACT
The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75 percent reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 8: Outbreaks, emergencies and disasters
/
Target 3.3: End transmission of communicable diseases
Database:
LILACS
Main subject:
Vancomycin
/
Cross Infection
/
Infection Control
/
Gram-Positive Bacterial Infections
/
Enterococcus
/
Vancomycin Resistance
/
Anti-Bacterial Agents
Type of study:
Evaluation study
/
Practice guideline
/
Observational study
/
Risk factors
Limits:
Child
/
Female
/
Humans
Language:
English
Journal:
Braz. j. med. biol. res
Journal subject:
Biology
/
Medicine
Year:
2012
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR