PMID- 22856512
OWN - NLM
STAT- MEDLINE
DCOM- 20121026
LR  - 20131121
IS  - 1560-7917 (Electronic)
IS  - 1025-496X (Linking)
VI  - 17
IP  - 30
DP  - 2012 Jul 26
TI  - Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a 
      large multihospital institution: a seven-year experience.
LID - 20229 [pii]
AB  - Repeated outbreaks of vancomycin-resistant Enterococcus faecium (VRE) occurred 
      between 2004 and 2010 in Assistance Publique--Hopitaux de Paris (AP-HP), a 
      23,000-bed multi-hospital institution. From August 2004 to December 2005, the 
      French guidelines for preventing cross-transmission of multiresistant bacteria 
      were applied. Because the number of VRE cases continued to increase, an 
      institutional control programme was implemented from January 2006 onwards: it 
      foresees stopping transfer of VRE and contact patients, separating VRE and 
      contact patients in distinct cohorts, intervention of a central infection control 
      team to support local teams, and quick application of measures as soon as first 
      VRE cases are identified. Between August 2004 and December 2010, 45 VRE outbreaks 
      occurred in 21 of the 38 AP-HP hospitals, comprising 533 cases. Time series 
      analysis showed that the mean number of cases increased by 0.8 cases per month 
      (95% confidence interval (CI): 0.3 to 1.3, p=0.001) before, and decreased by 0.7 
      cases per month after implementation of the programme (95% CI: -0.9 to -0.5, 
      p<0.001), resulting in a significant trend change of -1.5 cases per month (95% 
      CI: -2.1 to -0.9, p<0.001). The number of cases per outbreak was significantly 
      lower after implementation of the programme. A sustained and coordinated strategy 
      can control emerging bacteria at the level of a large regional multihospital 
      institution.
FAU - Fournier, S
AU  - Fournier S
AD  - Direction de la Politique Medicale-Directorate of Medical Politics, Assistance 
      Publique-Hopitaux de Paris, Paris, France. sandra.fournier@sap.aphp.fr
FAU - Brossier, F
AU  - Brossier F
FAU - Fortineau, N
AU  - Fortineau N
FAU - Gillaizeau, F
AU  - Gillaizeau F
FAU - Akpabie, A
AU  - Akpabie A
FAU - Aubry, A
AU  - Aubry A
FAU - Barbut, F
AU  - Barbut F
FAU - Chedhomme, F X
AU  - Chedhomme FX
FAU - Kassis-Chikhani, N
AU  - Kassis-Chikhani N
FAU - Lucet, J C
AU  - Lucet JC
FAU - Robert, J
AU  - Robert J
FAU - Seytre, D
AU  - Seytre D
FAU - Simon, I
AU  - Simon I
FAU - Vanjak, D
AU  - Vanjak D
FAU - Zahar, J R
AU  - Zahar JR
FAU - Brun-Buisson, C
AU  - Brun-Buisson C
FAU - Jarlier, V
AU  - Jarlier V
LA  - eng
PT  - Journal Article
DEP - 20120726
PL  - Sweden
TA  - Euro Surveill
JT  - Euro surveillance : bulletin Europeen sur les maladies transmissibles = European 
      communicable disease bulletin
JID - 100887452
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Anti-Bacterial Agents/pharmacology
MH  - Cross Infection/epidemiology/microbiology/*prevention & control
MH  - Disease Outbreaks/*prevention & control
MH  - Electrophoresis, Gel, Pulsed-Field
MH  - *Enterococcus faecium/drug effects/genetics/isolation & purification
MH  - France/epidemiology
MH  - Gram-Positive Bacterial Infections/drug 
      therapy/epidemiology/microbiology/*prevention & control
MH  - Hospital Bed Capacity, 500 and over
MH  - Hospitals, Teaching
MH  - Humans
MH  - Infection Control/*methods
MH  - Microbial Sensitivity Tests
MH  - Practice Guidelines as Topic
MH  - Program Evaluation
MH  - Prospective Studies
MH  - Vancomycin/pharmacology
MH  - *Vancomycin Resistance
EDAT- 2012/08/04 06:00
MHDA- 2012/10/27 06:00
CRDT- 2012/08/04 06:00
PHST- 2012/08/04 06:00 [entrez]
PHST- 2012/08/04 06:00 [pubmed]
PHST- 2012/10/27 06:00 [medline]
AID - 20229 [pii]
PST - epublish
SO  - Euro Surveill. 2012 Jul 26;17(30):20229.