Outbreak of vanB vancomycin-resistant Enterococcus faecium colonization in a neonatal service

Area of Science:

• Infectious Disease Epidemiology
• Neonatal Care
• Microbiology

Background:

• Neonatal intensive care units are vulnerable to healthcare-associated infections.
• Vancomycin-resistant Enterococcus faecium (VREfm) poses a significant threat to vulnerable infant populations.
• Controlling VREfm outbreaks requires multifaceted infection control strategies.

Purpose of the Study:

• To detail the successful containment of a VREfm colonization outbreak in a neonatal service.
• To evaluate the effectiveness of combined infection control measures in eliminating VREfm transmission.

Main Methods:

• Implementation of active surveillance cultures, patient isolation, and contact precautions.
• Enhanced environmental cleaning and targeted staff/parent education.
• Utilized whole genome sequencing and multilocus sequence typing for outbreak characterization.

Main Results:

• The outbreak peaked at 31% prevalence before interventions.
• Transmission ceased within 8 weeks, with no recurrences at 12 months.
• VREfm was detected on environmental surfaces, including weighing scales and a refrigerator.

Conclusions:

• Bundled infection control interventions effectively terminated a clonal VREfm outbreak in neonates.
• Strain-typing and surveillance were crucial for managing the outbreak.
• The neonatal unit's contained environment aided VREfm eradication.