[Interventions implemented to control an outbreak of vancomycin-resistant enterococci in a university hospital]

At the end of 2004, a Vancomycin-resistant enterococci (VRE) outbreak occurred in the university hospital of Nancy. Interventions were simultaneous implemented in this hospital (promotion of hand washing, gathering of VRE carriers in the same part of units) and the outbreak seemed to be controlled before the end of 2005. But one year later, the number of discovered new colonisations increased again. Then, promotion of exclusive hand disinfection with alcohol-based hand-rub solutions and cohorting of VRE carriers in a dedicate ward were the only two effective interventions to control the outbreak. At the beginning of the year 2007, before being controlled, this outbreak expanded to several other healthcare centres in Lorraine. A specific regional team was set up in July 2007. A programme to eradicate VRE was elaborated based on national guidelines modified and adapted regarding particularities of each situation. These new guidelines were published on an internet site. A list of all healthcare centres accommodating patients colonized with VRE is established weekly and diffused to all hospitals in Lorraine which then could optimise readmission conditions of potential VRE carriers or contact patients. Between 2004 and 2008, more than 900 patients were found colonized with VRE in Lorraine. Finally, the application of all the measures previously described, seemed to be efficient to control the ERV outbreak in Lorraine.