Related Experiment Videos
A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit
L V Karanfil1, M Murphy, A Josephson
1Epidemiology Department, University Hospital, SUNY-Health Science Center, Brooklyn.
Infection Control and Hospital Epidemiology
|April 1, 1992
Summary
A cluster of vancomycin-resistant Enterococcus faecium (VAREC) occurred in a cardiothoracic ICU. Prior vancomycin use and nosocomial infections were linked to VAREC acquisition, but modified isolation practices controlled its spread.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Vancomycin-resistant Enterococcus faecium (VAREC) poses a significant threat in healthcare settings.
- Understanding the epidemiology of VAREC clusters is crucial for effective control.
Purpose of the Study:
- To describe the epidemiology of a VAREC cluster in a cardiothoracic surgery intensive care unit (CSICU).
- To identify risk factors associated with VAREC acquisition.
- To evaluate the effectiveness of infection control interventions.
Main Methods:
- A case series approach was employed.
- Data were collected through surveillance, microbiologic records, and patient cultures.
- Statistical analyses, including Fisher's exact test and logistic regression, were used.
Main Results:
- Six patients in the CSICU developed VAREC with identical susceptibility patterns over six months.
- Prior vancomycin use (100%) and prior nosocomial infection (85.7%) were strongly associated with VAREC.
- VAREC was also detected in the environment.
- Modified contact isolation and cohorting successfully eliminated VAREC from the unit.
Conclusions:
- Prior vancomycin exposure, particularly in patients with nosocomial infections, increases VAREC risk.
- Patient-to-patient transmission of VAREC is a significant concern.
- Modified infection control practices, including enhanced isolation, are effective in controlling VAREC outbreaks.