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Dramatic increase in vancomycin-resistant enterococci in Germany.

Petra Gastmeier1, Christin Schröder2, Michael Behnke2

  • 1Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany German National Reference Centre for Surveillance of Nosocomial Infections (NRZ), Hindenburgdamm 27, 12203 Berlin, Germany petra.gastmeier@charite.de.

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Vancomycin-resistant Enterococcus faecium (VRE) infections significantly increased in German hospitals from 2007-2012. Regional variations were observed, with higher VRE proportions in western and eastern states, necessitating targeted infection control strategies.

Keywords:
epidemiologymultiresistantsurveillance

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Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Healthcare-Associated Infections

Background:

  • Germany exhibits a high proportion of vancomycin-resistant Enterococcus faecium (VRE) bloodstream infections among European nations.
  • Understanding the trends and geographical distribution of VRE is crucial for public health initiatives.

Purpose of the Study:

  • To investigate the development and temporal trends of vancomycin-resistant enterococci (VRE) in German hospitals.
  • To analyze the regional distribution of VRE across German federal states.

Main Methods:

  • Utilized data from the German national nosocomial surveillance system (KISS) between 2007 and 2012.
  • Analyzed intensive care unit (ICU) data (bloodstream infections, urinary tract infections), surgical site infections, and VRE cases (infections/colonizations).
  • Calculated trends over time and mapped VRE proportions by federal state.

Main Results:

  • Significant increases in VRE proportions were observed for surgical site infections (526%) and bloodstream infections (265%).
  • Urinary tract infections showed a non-significant increase (278%), while VRE cases in ICUs rose by 282%.
  • A notable variation in VRE proportions and incidence rates was found across German federal states, concentrated in a western-to-eastern belt.

Conclusions:

  • The high overall VRE burden in Germany is significantly influenced by specific states.
  • Detailed epidemiological analysis is urgently required to inform and develop effective VRE infection control strategies.