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Transmission of vancomycin-resistant enterococcus in a neonatal intensive care unit

Yoav Golan1, Shira Doron, Bernadette Sullivan

  • 1Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA. ygolan@tufts.nemc.org

The Pediatric Infectious Disease Journal
|June 4, 2005
PubMed

Insights

Vancomycin-resistant Enterococcus (VRE) outbreaks in NICUs can persist despite standard precautions. Cohorting incubators effectively halted transmission, highlighting the importance of targeting environmental contamination in infection control.

Area of Science:

  • Infectious Diseases
  • Neonatal Medicine
  • Healthcare Epidemiology

Background:

  • Vancomycin-resistant Enterococcus (VRE) poses a significant threat in neonatal intensive care units (NICUs).
  • Standard infection control measures, including contact precautions and patient/caregiver cohorting, were insufficient to contain a VRE outbreak.
  • Persistent transmission indicated a failure in existing infection control strategies.

Purpose of the Study:

  • To investigate the source of persistent vancomycin-resistant Enterococcus transmission in a NICU.
  • To evaluate the effectiveness of enhanced infection control measures targeting environmental contamination.

Main Methods:

  • Environmental sampling of incubators after terminal cleaning.
  • Identification of the VRE clone harbored by neonates.
  • Implementation of incubator cohorting as an additional infection control measure.

Main Results:

  • Incubators were identified as a reservoir for the neonates' specific VRE clone.
  • VRE transmission ceased following the implementation of incubator cohorting.
  • Environmental contamination was confirmed as a critical factor in VRE spread.

Conclusions:

  • Environmental contamination, specifically within incubators, played a crucial role in the persistent VRE outbreak.
  • Targeting environmental reservoirs is essential for effective VRE infection control in NICUs.
  • Incubator cohorting represents a successful strategy to mitigate VRE transmission linked to environmental sources.

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