PMID- 11886387
OWN - NLM
STAT- MEDLINE
DCOM- 20020419
LR  - 20220311
IS  - 0007-1048 (Print)
IS  - 0007-1048 (Linking)
VI  - 116
IP  - 4
DP  - 2002 Mar
TI  - Outbreak of vancomycin-resistant Enterococcus faecium in a haematology unit: risk 
      factor assessment and successful control of the epidemic.
PG  - 826-33
AB  - We describe an outbreak of vancomycin-resistant Enterococcus faecium (VRE) on the 
      haematology ward of a Dutch university hospital. After the occurrence of three 
      consecutive cases of bacteraemia with VRE, strains were genotyped and found to be 
      identical. During the next 4 months an intensive surveillance programme 
      identified 21 additional patients to be colonized with VRE, while two more 
      patients developed bacteraemia. A case-control study was carried out to identify 
      risk factors for VRE acquisition. In comparison with VRE-negative control 
      patients (n=49), cases (n=24) had a longer stay on the ward during the year 
      preceding the outbreak (25.8 versus 10.1 d, P=0.02), more cases with acute 
      myeloid leukaemia [11 versus 4, odds ratio (OR) 9.5, 95% confidence interval 
      (CI95) 2.4-32.2] and higher grades of mucositis (P=0.03). Logistic regression 
      analysis identified antibiotic use within 1 month before admission (OR 13.0, CI95 
      2.1-80.5, P=0.006) and low albumin levels at baseline (OR 1.2, CI95 1.1-1.3, 
      P=0.02) to be independent risk factors. Four patients with VRE-bacteraemia were 
      successfully treated with quinupristin/dalfopristin (Synercid). Control of the 
      outbreak was achieved by step-wise implementation of intensive infection control 
      measures, which included the cohorting of patients, allocation of nurses and 
      reinforcement of hand hygiene.
FAU - Timmers, Gert Jan
AU  - Timmers GJ
AD  - Department of Haematology, VU University Medical Centre, Amsterdam, the 
      Netherlands. GJ.Timmers@VUMC.nl
FAU - van der Zwet, Wil C
AU  - van der Zwet WC
FAU - Simoons-Smit, Ina M
AU  - Simoons-Smit IM
FAU - Savelkoul, Paul H M
AU  - Savelkoul PH
FAU - Meester, Helena H M
AU  - Meester HH
FAU - Vandenbroucke-Grauls, Christina M J E
AU  - Vandenbroucke-Grauls CM
FAU - Huijgens, Peter C
AU  - Huijgens PC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Serum Albumin)
RN  - 11006-76-1 (Virginiamycin)
RN  - 126602-89-9 (quinupristin-dalfopristin)
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/administration & dosage
MH  - Bacteremia
MH  - Case-Control Studies
MH  - *Cross Infection
MH  - Drug Therapy, Combination/therapeutic use
MH  - *Enterococcus faecium
MH  - Female
MH  - Gram-Positive Bacterial Infections/drug therapy/*transmission
MH  - *Hematology
MH  - *Hospital Departments
MH  - Humans
MH  - Infection Control
MH  - Length of Stay
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Patient Isolation
MH  - Risk Assessment
MH  - Serum Albumin/analysis
MH  - *Vancomycin Resistance
MH  - Virginiamycin/therapeutic use
EDAT- 2002/03/12 10:00
MHDA- 2002/04/20 10:01
CRDT- 2002/03/12 10:00
PHST- 2002/03/12 10:00 [pubmed]
PHST- 2002/04/20 10:01 [medline]
PHST- 2002/03/12 10:00 [entrez]
AID - 3339 [pii]
AID - 10.1046/j.0007-1048.2002.03339.x [doi]
PST - ppublish
SO  - Br J Haematol. 2002 Mar;116(4):826-33. doi: 10.1046/j.0007-1048.2002.03339.x.