Vancomycin-resistant Enterococcus faecium outbreak caused by patient transfer in 2 separate intensive care units

Area of Science:

• Infectious Disease Epidemiology
• Healthcare-Associated Infections
• Microbiology

Background:

• Vancomycin-resistant Enterococcus faecium (VRE) poses a significant threat in healthcare settings.
• Intensive care units (ICUs) are high-risk environments for the transmission of multidrug-resistant organisms.
• Simultaneous outbreaks in separate ICUs necessitate rapid investigation to identify transmission pathways.

Purpose of the Study:

• To investigate the cause of simultaneous vancomycin-resistant Enterococcus faecium (VRE) outbreaks in two intensive care units (ICUs).
• To determine the role of patient transfer in the dissemination of VRE colonization between ICUs.

Main Methods:

• Outbreak investigation was conducted involving clinical data review and microbiological analysis.
• Pulsed-field gel electrophoresis (PFGE) was utilized for molecular typing of Enterococcus faecium isolates.
• Patient movement and transfer records between ICUs were analyzed.

Main Results:

• Pulsed-field gel electrophoresis confirmed the genetic relatedness of VRE isolates from both ICUs.
• The transfer of a patient colonized with vancomycin-resistant Enterococcus faecium between the two ICUs was identified as a key event.
• This patient transfer directly contributed to the simultaneous VRE outbreaks in both intensive care units.

Conclusions:

• Patient transfers between intensive care units can facilitate the rapid spread of vancomycin-resistant Enterococcus faecium.
• Effective infection control measures, including careful patient placement and transfer protocols, are crucial to prevent inter-unit transmission.
• Molecular epidemiology tools like PFGE are essential for tracing the source and spread of outbreaks.