title: [Epidemiologic increase of various genotypes of vancomycin-resistant Enterococcus faecium in a university hospital].
abstract: After a report of a possible relationship between an outbreak of vancomycin-resistant enterococci (VRE) in a nearby hospital and earlier admission of two of the patients with this VRE in the University Medical Centre of Utrecht (UMCU), the Netherlands, an extensive search for VRE carriers was started in the UMCU. In the study period of two months, VRE carriership was diagnosed in 51 patients in nine of the 11 wards investigated. Twenty-six patients in eight wards were colonized with the same VRE genotype as in the nearby hospital; spread was demonstrated in three wards. In addition, six patients of one ward were colonized with a second genotype and seven other patients with a third genotype, while 12 patients were carriers of a unique genotype. Most carriers were found in the internal medicine/nephrology and dialysis ward. Far-reaching measures (such as cohort nursing, admission stops, use of gowns and gloves, disinfection and restriction of use of vancomycin) taken in the four wards where spread was demonstrated, appeared effective but in three wards, spread was again demonstrated later. Frequent readmissions and transfers of patients appear to play an important part in this matter. None of the 51 colonized patients developed a serious VRE infection.
authors.affiliation: Universitair Medisch Centrum Utrecht, Heidelberglaan 100, 3584 CX Utrecht.
authors.forename: E M
authors.initials: EM
authors.lastname: Mascini
authors.forename: A C
authors.initials: AC
authors.lastname: Gigengack-Baars
authors.forename: R J
authors.initials: RJ
authors.lastname: Hené
authors.forename: T E
authors.initials: TE
authors.lastname: Kamp-Hopmans
authors.forename: A J
authors.initials: AJ
authors.lastname: Weersink
authors.forename: M J
authors.initials: MJ
authors.lastname: Bonten
mesh_terms: D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks / Q000517:prevention & control; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification*; D005260:Female; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D006757:Hospital Units / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D018571:Sentinel Surveillance; D020713:Vancomycin Resistance / Q000235:genetics*