PMID- 22618895
OWN - NLM
STAT- MEDLINE
DCOM- 20120820
LR  - 20180802
IS  - 1424-3997 (Electronic)
IS  - 0036-7672 (Linking)
VI  - 142
DP  - 2012
TI  - Vancomycin-resistant Enterococcus.
PG  - w13540
LID - 10.4414/smw.2012.13540 [doi]
AB  - The reported prevalence of vancomycin-resistant Enterococcus faecium (VRE) in 
      Switzerland for the years 2008-2010 has been low at <5%. At the University 
      Hospital Zurich, 17 cases of VRE were detected between 28 December 2009 and 15 
      February 2010. Nine cases were diagnosed clinically; eight cases were detected by 
      rectal screening. The centre of the outbreak was the cardiac surgery department. 
      Four patients suffered from VRE-infections; four patients died. In order to 
      investigate and contain the outbreak, the following measures were taken: 
      prevalence surveys using weekly rectal screening, environmental screening; 
      selective enrichment culturing; pulsed field gel electrophoresis (PFGE) for 
      clonal typing and polymerase chain reaction-analysis (PCR) for resistance 
      determinants and virulence factors detection. Contact isolation in single rooms 
      and enhanced surface-disinfection methods were implemented. Ward nurses were 
      assigned as link nurses. Regular teaching was carried out aiming to improve hand 
      disinfection among healthcare workers. PFGE revealed two main pulsotypes each 
      including seven patients. Five minor pulsotypes originated from three additional 
      patients and one sample collected from a keyboard. Two of three patients with 
      minor pulsotypes had been treated abroad. PCR-analysis identified vanB 
      resistance-genotypes with exception of one vanA resistance-genotype. The outbreak 
      was associated with environmental contamination and insufficient compliance with 
      hand-hygiene. Enhanced awareness and infection control measures resulted in 
      termination of the VRE outbreak within eight weeks. The complexity of the 
      outbreak with several clones in parallel suggests a higher baseline prevalence of 
      VRE in Switzerland than previous surveillance data indicate.
FAU - Thierfelder, Clara
AU  - Thierfelder C
AD  - Division of Infectious Diseases and Hospital Epidemiology, University Hospital 
      Zurich, University of Zurich, Switzerland. clara.thierfelder@hotmail.com
FAU - Keller, Peter Michael
AU  - Keller PM
FAU - Kocher, Claudine
AU  - Kocher C
FAU - Gaudenz, Roman
AU  - Gaudenz R
FAU - Hombach, Michael
AU  - Hombach M
FAU - Bloemberg, Guido Vincent
AU  - Bloemberg GV
FAU - Ruef, Christian
AU  - Ruef C
LA  - eng
PT  - Journal Article
DEP - 20120522
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
RN  - 0 (Anti-Bacterial Agents)
RN  - 61036-62-2 (Teicoplanin)
SB  - IM
CIN - Swiss Med Wkly. 2012;142:w13554. PMID: 22618968
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Cross Infection/drug therapy/microbiology/*prevention & control
MH  - Disease Outbreaks/*prevention & control
MH  - Electrophoresis, Gel, Pulsed-Field
MH  - Enterococcus faecium/*isolation & purification
MH  - Equipment Contamination
MH  - Female
MH  - Gram-Positive Bacterial Infections/*diagnosis/drug 
      therapy/*epidemiology/microbiology
MH  - Hand Disinfection
MH  - Hospitals
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Patient Isolation
MH  - Polymerase Chain Reaction
MH  - Prevalence
MH  - Rectum/microbiology
MH  - Switzerland/epidemiology
MH  - Teicoplanin/therapeutic use
MH  - *Vancomycin Resistance
EDAT- 2012/05/24 06:00
MHDA- 2012/08/21 06:00
CRDT- 2012/05/24 06:00
PHST- 2012/05/24 06:00 [entrez]
PHST- 2012/05/24 06:00 [pubmed]
PHST- 2012/08/21 06:00 [medline]
AID - smw-13540 [pii]
AID - 10.4414/smw.2012.13540 [doi]
PST - epublish
SO  - Swiss Med Wkly. 2012 May 22;142:w13540. doi: 10.4414/smw.2012.13540. eCollection 
      2012.