scholarly journals A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Stefanie Kampmeier ◽  
Hauke Tönnies ◽  
Carlos L. Correa-Martinez ◽  
Alexander Mellmann ◽  
Vera Schwierzeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Whole Genome Sequence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Abstract Background Currently, hospitals have been forced to divert substantial resources to cope with the ongoing coronavirus disease 2019 (COVID-19) pandemic. It is unclear if this situation will affect long-standing infection prevention practices and impact on healthcare associated infections. Here, we report a nosocomial cluster of vancomycin-resistant enterococci (VRE) that occurred on a COVID-19 dedicated intensive care unit (ICU) despite intensified contact precautions during the current pandemic. Whole genome sequence-based typing (WGS) was used to investigate genetic relatedness of VRE isolates collected from COVID-19 and non-COVID-19 patients during the outbreak and to compare them to environmental VRE samples. Methods Five VRE isolated from patients (three clinical and two screening samples) as well as 11 VRE and six vancomycin susceptible Enterococcus faecium (E. faecium) samples from environmental sites underwent WGS during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). Results WGS revealed two genotypic distinct VRE clusters with genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control bundle strategies. Conclusions Our results illustrate the importance of continued adherence to infection prevention and control measures during the COVID-19 pandemic to prevent VRE transmission and healthcare associated infections.

Management of an Outbreak of Vancomycin-Resistant Enterococci in the Medical Intensive Care Unit of a Cancer Center

2001 ◽  
Vol 22 (4) ◽  
pp. 217-219 ◽  
Author(s):  
Hend Hanna ◽  
Jan Umphrey ◽  
Jeffrey Tarrand ◽  
Michelle Mendoza ◽  
Issam Raad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Control Measures ◽  
Cancer Center ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Medical Intensive Care ◽  
Vancomycin Resistant

AbstractBetween November 1996 and February 1997, 17 episodes of vancomycin-resistant enterococci (VRE) infection or colonization (9 infections, 8 colonizations), all with the same or a similar genomic DNA pattern, were identified in the medical intensive care unit (MICU) of a tertiary-care cancer hospital. The cases were genotypically traced to a patient who was admitted to the hospital in September 1996 and who, by December 1996, had four different admissions to the MICU. Multifaceted infection control measures, including decontamination of the environment and of nondisposable equipment, halted the nosocomial transmission of VRE in the MICU.

Legislative Mandates for Use of Active Surveillance Cultures to Screen for Methicillin-ResistantStaphylococcus aureusand Vancomycin-Resistant Enterococci: Position Statement From the Joint SHEA and APIC Task Force

2007 ◽  
Vol 28 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Stephen G. Weber ◽  
Susan S. Huang ◽  
Shannon Oriola ◽  
W. Charles Huskins ◽  
Gary A. Noskin ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Task Force ◽  
Position Statement ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant ◽  
State And Local ◽  
Healthcare Associated

Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association of Professionals in Infection Control and Epidemiology (APIC) have developed this joint position statement. Both organizations are dedicated to combating healthcare-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistantStaphylococcus aureus(MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, APIC and SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) SHEA and APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) APIC and SHEA welcome efforts by healthcare consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and healthcare-associated infections. (4) SHEA and APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) APIC and SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.

A Decrease in the Number of Cases of Necrotizing Enterocolitis Associated with the Enhancement of Infection Prevention and Control Measures during aStaphylococcus aureusOutbreak in a Neonatal Intensive Care Unit

2012 ◽  
Vol 33 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Brigitte Lemyre ◽  
Wenlong Xiu ◽  
Nicole Rouvinez Bouali ◽  
Janet Brintnell ◽  
Jo-Anne Janigan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Prevention And Control Measures ◽  
And Control

Objective.Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.Design.Retrospective chart review.Setting.A 24-bed, university-affiliated, inborn level 3 NICU.Participants.Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.Interventions.Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.Results.Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).Conclusion.Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.Infect Control Hosp Epidemiol2012;33(1):29-33

scholarly journals Healthcare-associated infections in Intensive Care Units: epidemiology and infection control in low-to-middle income countries

2015 ◽  
Vol 9 (10) ◽  
pp. 1040-1045 ◽  
Author(s):  
Emine Alp ◽  
Nizam Damani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Middle Income ◽  
Middle Income Countries ◽  
Healthcare Associated ◽  
And Control

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

scholarly journals Results of screening for emergent highly resistant bacteria in Tunisian intensive care units

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ben Rejeb ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
M Kahloul ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Early Identification ◽  
Infection Prevention ◽  
Screening Program ◽  
Control Measures ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Resistant Bacteria ◽  
Prevention Interventions

Abstract Background The infections caused by emergent highly resistant bacteria (eHBR) that develop in intensive care units (ICUs) may result in significant patient illnesses and deaths, extend the duration of hospital stays and generate added costs. Facing this problem, the screening that emphasizes early identification of colonized patients, reduces the prevalence and incidence of infection, improves patient outcomes and reduces healthcare costs. In this context, we have implemented a screening for eHBR in ICUs of Sahloul university hospital of Sousse (Tunisia), which we report in this study the first six-months outcomes. Methods Rectal swab cultures were collected to detect Vancomycin resistant enterococcus (VRE) and Carbapenemase producing Enterobacteriaceae (CPE) among patients admitted in six ICUs of Sahloul university hospital of Sousse (Tunisia) and more than three times, at least one week apart, between 1 June and 31 December 2018. Results During the study period 174 patients were screened. Of them, 69.5% were male and 73.6% were admitted in surgical ICU. In total, 161 and 152 samples were realized respectively for the detection of CPE and VRE. These samples were positive in 15% and 8.5% respectively for CPE and VRE. Klebsiella pneumoniae OXA 48 was the most isolated CPE (80%). Conclusions Our screening program helped us in infection control by early identification of patients, thereby facilitating an informed decision about infection prevention interventions. Moreover, these results encouraged us to improve and generalize this program throughout the hospital. Key messages eHRB screening becomes an important axis in the prevention of eHRB infections in our facilities. eHRB screening allows the reinforcement of the basic infection prevention and control measures.

scholarly journals Longitudinal Trends in All Healthcare-Associated Infections through Comprehensive Hospital-wide Surveillance and Infection Control Measures over the Past 12 Years: Substantial Burden of Healthcare-Associated Infections Outside of Intensive Care Units and “Other” Types of Infection

2015 ◽  
Vol 36 (10) ◽  
pp. 1139-1147 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
Lauren M. DiBiase ◽  
Emily E. Sickbert-Bennett ◽  
Rebecca Brooks ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Linear Models ◽  
Infection Type ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Control Measures ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETargeted surveillance has focused on device-associated infections and surgical site infections (SSIs) and is often limited to healthcare-associated infections (HAIs) in high-risk areas. Longitudinal trends in all HAIs, including other types of HAIs, and HAIs outside of intensive care units (ICUs) remain unclear. We examined the incidences of all HAIs using comprehensive hospital-wide surveillance over a 12-year period (2001–2012).METHODSThis retrospective observational study was conducted at the University of North Carolina (UNC) Hospitals, a tertiary care academic facility. All HAIs, including 5 major infections with 14 specific infection sites as defined using CDC criteria, were ascertained through comprehensive hospital-wide surveillance. Generalized linear models were used to examine the incidence rate difference by infection type over time.RESULTSA total of 16,579 HAIs included 6,397 cases in ICUs and 10,182 cases outside ICUs. The incidence of overall HAIs decreased significantly hospital-wide (−3.4 infections per 1,000 patient days), in ICUs (−8.4 infections per 1,000 patient days), and in non-ICU settings (−1.9 infections per 1,000 patient days). The incidences of bloodstream infection, urinary tract infection, and pneumonia in hospital-wide settings decreased significantly, but the incidences of SSI and lower respiratory tract infection remained unchanged. The incidence of Clostridium difficile infection (CDI) increased remarkably. The outcomes were estimated to include 700 overall HAIs prevented, 40 lives saved, and cost savings in excess of $10 million.CONCLUSIONSWe demonstrated success in reducing overall HAIs over a 12-year period. Our data underscore the necessity for surveillance and infection prevention interventions outside of the ICUs, for non–device-associated HAIs, and for CDI.Infect Control Hosp Epidemiol 2015;36(10):1139–1147

Sign in / Sign up

Export Citation Format

Share Document