Epidemiology and control of vancomycin-resistant enterococci in a regional neonatal intensive care unit.
BACKGROUND
After the occurrence of two cases of bloodstream infection with vancomycin-resistant enterococci (VRE) in our regional neonatal intensive care unit, we studied the epidemiology of VRE and applied extensive infection control measures to the unit to control VRE transmission.


METHODS
Infection control measures applied to the unit included weekly surveillance for VRE colonization; education; cohorting of VRE-positive, VRE-negative and VRE-exposed babies with separate personnel and equipment for each group; use of gowns and gloves on room entry; and hand washing before and after each patient contact. Risk factors for VRE colonization were determined with a stepwise logistic regression model.


RESULTS
Thirty-three (40.2%) babies became colonized with VRE. The VRE colonization rate was reduced from 67% to 7% after implementation of infection control measures. Prolonged antimicrobial treatment and low birth weight were significantly associated with an increased risk of VRE colonization.


CONCLUSIONS
VRE can spread rapidly among newborns in a regional neonatal intensive care unit. Strict infection control measures can reduce the rate of VRE colonization among neonates.
Malik
R K
RK
Division of Neonatology, New York Medical College, Valhalla 10595, USA.
Montecalvo
M A
MA
Reale
M R
MR
Li
K
K
Maw
M
M
Munoz
J L
JL
Gedris
C
C
van Horn
K
K
Carnevale
K A
KA
Levi
M H
MH
Dweck
H S
HS
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control; D007363:Intensive Care Units, Neonatal; D012307:Risk Factors; D014640:Vancomycin / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D014640:Vancomycin