Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region
Vancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 i...
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| Veröffentlicht in: | Emerging health threats journal 2009, Vol.2, p.e9-e9 |
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| creator | Cheng, V C C Chan, J F W Tai, J W M Ho, Y Y Li, I W S To, K K W Ho, P L Yuen, K Y |
| description | Vancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P=0.047), presence of nasogastric tubing (P=0.002) and tracheostomy (P |
| doi_str_mv | 10.3134/ehtj.09.009 |
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We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P=0.047), presence of nasogastric tubing (P=0.002) and tracheostomy (P<0.001), and the use of β-lactam antibiotics (P<0.001) and vancomycin (P=0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients' immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.</description><identifier>ISSN: 1752-8550</identifier><identifier>EISSN: 1752-8550</identifier><identifier>DOI: 10.3134/ehtj.09.009</identifier><identifier>PMID: 22460290</identifier><language>eng</language><publisher>Sweden: CoAction Publishing</publisher><subject>Enterococcus faecium ; Original s</subject><ispartof>Emerging health threats journal, 2009, Vol.2, p.e9-e9</ispartof><rights>2010 VCC Cheng .; licensee Emerging Health Threats Journal 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167649/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167649/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22460290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, V C C</creatorcontrib><creatorcontrib>Chan, J F W</creatorcontrib><creatorcontrib>Tai, J W M</creatorcontrib><creatorcontrib>Ho, Y Y</creatorcontrib><creatorcontrib>Li, I W S</creatorcontrib><creatorcontrib>To, K K W</creatorcontrib><creatorcontrib>Ho, P L</creatorcontrib><creatorcontrib>Yuen, K Y</creatorcontrib><title>Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region</title><title>Emerging health threats journal</title><addtitle>Emerg Health Threats J</addtitle><description>Vancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P=0.047), presence of nasogastric tubing (P=0.002) and tracheostomy (P<0.001), and the use of β-lactam antibiotics (P<0.001) and vancomycin (P=0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients' immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.</description><subject>Enterococcus faecium</subject><subject>Original s</subject><issn>1752-8550</issn><issn>1752-8550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNpVkctLHTEUh0Ox1Ee76l6yc1HmNo95ZSPIxdaC0EXdh8zJyTV2JtE8LvjfO6IVu8qBfPzO4yPkK2cbyWX7HW_L3YapDWPqAzniQyeasevYwbv6kBznfMdYL4UYPpFDIdqeCcWOyP5PBcCcXZ0pxFBSnGl0dG8CxOURfGgSZp-LCYVehoIpQgSomTqD4OtCYy1TQvOX-kANDVhTzDXtPJiZ1uALNYWGGBoMFhcPNOHOx_CZfHRmzvjl9T0hNz8ub7ZXzfXvn7-2F9cNCN6pRo2WTaNsJ5SDY9YMzvQgQCrXd8KhsEK4aVKdtWid7G0P3LhxEhwmDgOXJ-T8Jfa-TgtawHVBM-v75BeTHnU0Xv__E_yt3sW9lrwf-latAWevASk-VMxFLz4DzrMJGGvWQ9eOSrXdsJLfXkhYD5ATurcunOlnT_rZk2ZKr55W-vT9YG_sPzHyCQ_KlCQ</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>Cheng, V C C</creator><creator>Chan, J F W</creator><creator>Tai, J W M</creator><creator>Ho, Y Y</creator><creator>Li, I W S</creator><creator>To, K K W</creator><creator>Ho, P L</creator><creator>Yuen, K Y</creator><general>CoAction Publishing</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>2009</creationdate><title>Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region</title><author>Cheng, V C C ; Chan, J F W ; Tai, J W M ; Ho, Y Y ; Li, I W S ; To, K K W ; Ho, P L ; Yuen, K Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2159-98d0b834be37f0da7fa6c2c39f652fe2d22fbb95ddedf36d6c1af8b21cb1c713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Enterococcus faecium</topic><topic>Original s</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, V C C</creatorcontrib><creatorcontrib>Chan, J F W</creatorcontrib><creatorcontrib>Tai, J W M</creatorcontrib><creatorcontrib>Ho, Y Y</creatorcontrib><creatorcontrib>Li, I W S</creatorcontrib><creatorcontrib>To, K K W</creatorcontrib><creatorcontrib>Ho, P L</creatorcontrib><creatorcontrib>Yuen, K Y</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Emerging health threats journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, V C C</au><au>Chan, J F W</au><au>Tai, J W M</au><au>Ho, Y Y</au><au>Li, I W S</au><au>To, K K W</au><au>Ho, P L</au><au>Yuen, K Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region</atitle><jtitle>Emerging health threats journal</jtitle><addtitle>Emerg Health Threats J</addtitle><date>2009</date><risdate>2009</risdate><volume>2</volume><spage>e9</spage><epage>e9</epage><pages>e9-e9</pages><issn>1752-8550</issn><eissn>1752-8550</eissn><abstract>Vancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P=0.047), presence of nasogastric tubing (P=0.002) and tracheostomy (P<0.001), and the use of β-lactam antibiotics (P<0.001) and vancomycin (P=0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients' immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.</abstract><cop>Sweden</cop><pub>CoAction Publishing</pub><pmid>22460290</pmid><doi>10.3134/ehtj.09.009</doi><oa>free_for_read</oa></addata></record> |
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| source | Co-Action Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
| subjects | Enterococcus faecium Original s |
| title | Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region |
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