scholarly journals First Report of Nosocomial Outbreak of Vancomycin-Resistant Enterococcus Faecium Infection Among COVID-19 Patients Hospitalized in a Non-Intensive Care Unit Ward in Central Europe

2021 ◽  
Author(s):  
Yashar Jalali ◽  
Igor Šturdík ◽  
Monika Jalali ◽  
Ján Kyselovič ◽  
Adriána Liptáková ◽  
...  
Keyword(s):  
Infection Control ◽  
Central Europe ◽  
Control Strategies ◽  
Health Care Systems ◽  
Blood Stream ◽  
Control Measures ◽  
Outbreak Investigation ◽  
Strain Identification ◽  
Strict Adherence ◽  
Vancomycin Resistant

Abstract Background: The COVID-19 pandemic in 2020 exerted immense pressure on health care systems worldwide, causing substantial resources to be diverted to respond to the pandemic. These changes raise the concern about the potential for reduction in adherence to long-established measures in the prevention of healthcare-associated infections (HAI). Enterococcus species account for most of human enterococcal HAI and multidrug-resistant infections and have become a major threat to modern public health. We examine the rise in the number of vancomycin resistant E. faecium blood stream and urinary tract infections in a COVID-19 department during an epidemiologic outbreak investigation to detect and eliminate nosocomial clusters of the bacteria. Methods: Strain identification was performed by classical isolation and biochemical and cultivation methods. Antibiotic testing results were interpreted according to European committee on antimicrobial susceptibility testing (EUCAST) guidelines. Six isolated samples underwent whole genome sequencing (WGS) during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing.Results: WGS revealed two genotypically distinct VRE clusters, one of which had genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control strategies.Conclusions: This study provides the first description of an outbreak caused by vanA-ST17 E. faecium strains among COVID-19 patients in central Europe, and the first description of an outbreak caused by vanB-ST117 and vanA-ST17 E. faecium strains in Slovakia. This study can help raise awareness about the need for strict adherence to infection control measures and the implementation of rational antimicrobial stewardship as a routine part of COVID-19 management.

Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

2001 ◽  
Vol 22 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Marisa A. Montecalvo ◽  
William R. Jarvis ◽  
Jane Uman ◽  
David K. Shay ◽  
Coleen Petrullo ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Strategies ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Mixed Effect ◽  
Infection Control Program ◽  
Endemic Setting ◽  
Vancomycin Resistant Enterococci ◽  
Number Of Patients ◽  
Vancomycin Resistant

AbstractObjective:To determine the costs and savings of a 15-component infection control program that reduced transmission of vancomycin-resistant enterococci (VRE) in an endemic setting.Design:Evaluation of costs and savings, using historical control data.Setting:Adult oncology unit of a 650-bed hospital.Participants:Patients with leukemia, lymphoma, and solid tumors, excluding bone marrow transplant recipients.Methods:Costs and savings with estimated ranges were calculated. Excess length of stay (LOS) associated with VRE bloodstream infection (BSI) was determined by matching VRE BSI patients with VRE-negative patients by oncology diagnosis. Differences in LOS between the matched groups were evaluated using a mixed-effect analysis of variance linear-regression model.Results:The cost of enhanced infection control strategies for 1 year was $116,515. VRE BSI was associated with an increased LOS of 13.7 days. The savings associated with fewer VRE BSI ($123,081), fewer patients with VRE colonization ($2,755), and reductions in antimicrobial use ($179,997) totaled $305,833. Estimated ranges of costs and savings for enhanced infection control strategies were $97,939 to $148,883 for costs and $271,531 to $421,461 for savings.Conclusion:The net savings due to enhanced infection control strategies for 1 year was $189,318. Estimates suggest that these strategies would be cost-beneficial for hospital units where the number of patients with VRE BSI is at least see to nine patients per year or if the savings from fewer VRE BSI patients in combination with decreased antimicrobial use equalled $100,000 to $150,000 per year.

scholarly journals Potential impact of seasonal forcing on a SARS-CoV-2 pandemic

2020 ◽  
Author(s):  
Richard A. Neher ◽  
Robert Dyrdak ◽  
Valentin Druelle ◽  
Emma B. Hodcroft ◽  
Jan Albert
Keyword(s):  
Seasonal Variation ◽  
Infection Control ◽  
Transmission Rate ◽  
Health Care Systems ◽  
Control Measures ◽  
Rate Variation ◽  
Small Peak ◽  
Infection Control Measures ◽  
Care Systems ◽  
Novel Coronavirus

A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 80,000 confirmed infections and 2,700 fatalities (as of Feb 27, 2020). Imported cases and transmission clusters of various sizes have been reported globally suggesting a pandemic is likely.Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterize our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions.While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained. Seasonal forcing on SARS-CoV-2 should thus be taken into account in the further monitoring of the global transmission. The likely aggregated effect of seasonal variation, infection control measures, and transmission rate variation is a prolonged pandemic wave with lower prevalence at any given time, thereby providing a window of opportunity for better preparation of health care systems.

scholarly journals Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting

2016 ◽  
Vol 54 (10) ◽  
pp. 2436-2447 ◽  
Author(s):  
Matthew L. Faron ◽  
Nathan A. Ledeboer ◽  
Blake W. Buchan
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Control Strategies ◽  
Resistance Mechanisms ◽  
Clinical Microbiology Laboratory ◽  
Laboratory Methods ◽  
Content Type ◽  
Important Health ◽  
Vancomycin Resistant ◽  
Hospital Acquired

Infections attributable to vancomycin-resistantEnterococcus(VRE) strains have become increasingly prevalent over the past decade. Prompt identification of colonized patients combined with effective multifaceted infection control practices can reduce the transmission of VRE and aid in the prevention of hospital-acquired infections (HAIs). Increasingly, the clinical microbiology laboratory is being asked to support infection control efforts through the early identification of potential patient or environmental reservoirs. This review discusses the factors that contribute to the rise of VRE as an important health care-associated pathogen, the utility of laboratory screening and various infection control strategies, and the available laboratory methods to identify VRE in clinical specimens.

First Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a Tertiary Care Hospital in Singapore

2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  
Keyword(s):  
Infection Control ◽  
Enterococcus Faecium ◽  
Public Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Vancomycin Resistant

We report the first outbreak of vancomycin-resistantEnterococcus faeciumcolonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.

Infection-Control Measures Reduce Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

1999 ◽  
Vol 131 (4) ◽  
pp. 269 ◽  
Author(s):  
Marisa A. Montecalvo ◽  
William R. Jarvis ◽  
Jane Uman ◽  
David K. Shay ◽  
Coleen Petrullo ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Endemic Setting ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Emergence of Vancomycin-Resistant Enterococci in San Francisco Bay Area Hospitals During 1994 to 1998

2004 ◽  
Vol 25 (5) ◽  
pp. 408-412 ◽  
Author(s):  
Jon Rosenberg ◽  
William R. Jarvis ◽  
Sharon L. Abbott ◽  
Due J. Vugia ◽  
Keyword(s):  
Infection Control ◽  
San Francisco ◽  
San Francisco Bay ◽  
San Francisco Bay Area ◽  
Control Measures ◽  
Emerging Infections ◽  
Bay Area ◽  
Infection Control Measures ◽  
Vancomycin Resistant ◽  
Rapid Emergence

AbstractObjective:To determine the magnitude of van-comycin-resistant enterococci (VRE) in three counties in the San Francisco Bay area.Design:Active laboratory-based surveillance for VRE from January 1995 through December 1996 and a laboratory-based and hospital-based questionnaire survey for 1993 to 1994 and 1997 to 1998.Setting:All 33 general acute care hospitals in three counties in the San Francisco Bay area.Participants:Laboratories and infection control professionals serving these hospitals, and staff of the California Emerging Infections Program.Results:The number of hospitals reporting 1 or more patient clinical VRE isolates was 1 (3%) in 1993, 7 (21%) in 1994, 31 (94%) in 1995, and 33 (100%) in 1996 to 1998. The number of patient isolates increased from 1 in 1993 to 24 in 1994, 176 in 1995,429 in 1996, 730 in 1997, and 864 in 1998. Most VRE isolates in 1995 and 1996 were from urine and were not associated with serious clinical disease. However, the number of isolates from blood increased from 9 (6% of total) in 1995 to 44 (12% of the total) in 1996, 90 (14%) in 1997, and 100 (13%) in 1998.Conclusions:Our data document the rapid emergence and increase of VRE in all hospitals in three counties in the San Francisco Bay area during 1994 to 1998. Infection control measures for VRE together with antibiotic utilization programs should be implemented to limit further spread.

scholarly journals Vancomycin-Resistant Enterococci: The Value of Infection Control and Antibiotic Control Policy

2006 ◽  
Vol 17 (suppl b) ◽  
pp. 9B-12B ◽  
Author(s):  
Karl Weiss
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Health Care System ◽  
Control Measures ◽  
Canadian Health Care System ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Canadian Health ◽  
Canadian Health Care ◽  
Vancomycin Resistant

Vancomycin-resistant enterococci (VRE) represent a major challenge for the Canadian health care system. The clinical significance of VRE in the Canadian health care system has increased over the past two decades, with outbreaks reported in Ontario and Quebec, although most provinces have been affected. This organism has been a substantial human and financial burden for Canadian institutions. VRE have been shown to be associated with an increased mortality, a longer hospital stay and a much higher overall cost compared with vancomycinsusceptible strains. Enterococci are now the third most important nosocomial pathogen in American intensive care units. The two most common species,Enterococcus faecalisandEnterococcus faecium, have shown remarkable adaptability in responding to antibiotics. The arrival of VRE in Canada has forced hospitals to implement stringent and costly infection control measures. A multifaceted approach, including antibiotic restriction and stringent infection control measures, is important in managing VRE prevalence in Canadian institutions.

scholarly journals Epidemiological analysis of Elizabethkingia meningoseptica infection cluster among mechanically ventilated pediatric intensive care patients

2018 ◽  
Vol 5 (8) ◽  
pp. 3212 ◽  
Author(s):  
Wafaa Seddik Hamza ◽  
Samar Saeed Morsi ◽  
Ebtehal Saleh Al Roomi ◽  
Vincent Olubunmi Rotimi
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Blood Stream Infection ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Control Measures ◽  
Mechanically Ventilated ◽  
Infection Control Measures ◽  
Elizabethkingia Meningoseptica ◽  
Healthcare Associated

Background: Elizabethkingia meningoseptica is frequently found in hospital environments and usually associated with healthcare-associated infections (HAIs), particularly in patients in the intensive care units (ICU). The current study report an outbreak of E. meningoseptica infection/colonization in the pediatric intensive care unit, highlighted the infection control methods used to stem the spread.Methods: During a period of 7 months, May-November 2015, 4 patients were infected/ colonized by E. meningoseptica. Infection control measures were re-emphasized after each case and environmental swabs were cultured to detect possible source. Follow up for 25 months to ensure eradication of the pathogen.Results: Four patients were colonized/ infected with E. meningoseptica, their mean age 22 months. The average time patients spent in ICU between admission and isolation of E. meningoseptica was 27.5±19.2 days. All patients were mechanically ventilated. 25% E. meningoseptica isolated from blood causing healthcare associated Central Line Associated Blood Stream Infection (CLABSI) while it was isolated from endotracheal tube (ETT) secretion in 75% as healthcare associated colonization. The 4 isolates confirmed as identical using pulsed field gel electrophoresis (PFGE).Conclusions: Intensive infection control measures including healthcare workers education, emphasizing hand hygiene, comprehensive cleaning and disinfection of equipment and the environment are important to eradicate the bacterium.

scholarly journals The COVID-19 pandemic in Norway and Sweden – threats, trust, and impact on daily life: A comparative survey

2020 ◽  
Author(s):  
Lise Helsingen ◽  
Erle Refsum ◽  
Dagrun Kyte Gjøstein ◽  
Magnus Løberg ◽  
Michael Bretthauer ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Preventive Measures ◽  
Daily Life ◽  
Health Care Systems ◽  
School Closure ◽  
Control Measures ◽  
Mitigation Measures ◽  
Infection Control Measures ◽  
Care Systems

Abstract Background: Norway and Sweden have similar populations and health care systems, but different reactions to the COVID-19 pandemic. Norway closed educational institutions, and banned sports and cultural activities; Sweden kept most institutions and training facilities open. We aimed to compare peoples’ attitudes towards authorities and control measures, and perceived impact of the pandemic and implemented control measures on life in Norway and Sweden.Methods: Anonymous web-based surveys for individuals age 15 or older distributed through Facebook using the snowball method, in Norway and Sweden from mid-March to mid-April, 2020. The survey contained questions about perceived threat of the pandemic, views on infection control measures, and impact on daily life. We performed descriptive analyses of the responses and compared the two countries.Results: 3,508 individuals participated in the survey (Norway 3000; Sweden 508). 79% were women, the majority were 30-49 years (Norway 60%; Sweden 47%), and about 45% of the participants in both countries had more than four years of higher education.Participants had high trust in the health services, but differed in the degree of trust in their government (High trust in Norway 17%; Sweden 37%). More Norwegians than Swedes agreed that school closure was a good measure (Norway 66%; Sweden 18%), that countries with open schools were irresponsible (Norway 65%; Sweden 23%), and that the threat from repercussions of the mitigation measures were large or very large (Norway 71%; Sweden 56%). Both countries had a high compliance with infection preventive measures (> 98%). Many lived a more sedentary life (Norway 69%; Sweden 50%) and ate more (Norway 44%; Sweden 33%) during the pandemic. Conclusion: Sweden had more trust in the authorities, while Norwegians reported a more negative lifestyle during the pandemic. The level of trust in the health care system and self-reported compliance with preventive measures was high in both countries despite the differences in infection control measures.

scholarly journals The COVID-19 pandemic in Norway and Sweden – threats, trust, and impact on daily life: a comparative survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lise M. Helsingen ◽  
◽  
Erle Refsum ◽  
Dagrun Kyte Gjøstein ◽  
Magnus Løberg ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Preventive Measures ◽  
Daily Life ◽  
Health Care Systems ◽  
School Closure ◽  
Control Measures ◽  
Mitigation Measures ◽  
Infection Control Measures ◽  
Care Systems

Abstract Background Norway and Sweden have similar populations and health care systems, but different reactions to the COVID-19 pandemic. Norway closed educational institutions, and banned sports and cultural activities; Sweden kept most institutions and training facilities open. We aimed to compare peoples’ attitudes towards authorities and control measures, and perceived impact of the pandemic and implemented control measures on life in Norway and Sweden. Methods Anonymous web-based surveys for individuals age 15 or older distributed through Facebook using the snowball method, in Norway and Sweden from mid-March to mid-April, 2020. The survey contained questions about perceived threat of the pandemic, views on infection control measures, and impact on daily life. We performed descriptive analyses of the responses and compared the two countries. Results 3508 individuals participated in the survey (Norway 3000; Sweden 508). 79% were women, the majority were 30–49 years (Norway 60%; Sweden 47%), and about 45% of the participants in both countries had more than 4 years of higher education. Participants had high trust in the health services, but differed in the degree of trust in their government (High trust in Norway 17%; Sweden 37%). More Norwegians than Swedes agreed that school closure was a good measure (Norway 66%; Sweden 18%), that countries with open schools were irresponsible (Norway 65%; Sweden 23%), and that the threat from repercussions of the mitigation measures were large or very large (Norway 71%; Sweden 56%). Both countries had a high compliance with infection preventive measures (> 98%). Many lived a more sedentary life (Norway 69%; Sweden 50%) and ate more (Norway 44%; Sweden 33%) during the pandemic. Conclusion Sweden had more trust in the authorities, while Norwegians reported a more negative lifestyle during the pandemic. The level of trust in the health care system and self-reported compliance with preventive measures was high in both countries despite the differences in infection control measures.

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