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
Artigo
em Inglês
| LILACS
| ID: lil-614578
Biblioteca responsável:
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 8: Surtos, emergências e desastres
/
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Base de dados:
LILACS
Assunto principal:
Vancomicina
/
Infecção Hospitalar
/
Controle de Infecções
/
Infecções por Bactérias Gram-Positivas
/
Enterococcus
/
Resistência a Vancomicina
/
Antibacterianos
Tipo de estudo:
Estudo de avaliação
/
Guia de prática clínica
/
Estudo observacional
/
Fatores de risco
Limite:
Criança
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Braz. j. med. biol. res
Assunto da revista:
Biologia
/
Medicina
Ano de publicação:
2012
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de São Paulo/BR