Outbreak of vancomycin-resistant enterococci (VRE) in a hematological oncology ward and hygienic preventive measures. A long-term study.
BACKGROUND
We report on two endemic outbreaks of VRE (vancomycin-resistant enterococci, vanA type Enterococcus faecium) on a hematological oncology ward in a university hospital and a new strategic concept to fight against spread of VRE.


METHODS
During management of the outbreak, a total of 1,124 patients and 1,700 specimens were investigated from June 1999 to December 2001. Protective measures were instituted. Intensive prophylactic infection control was practiced until December 2003.


RESULTS
Of the 1,124 patients, 44 were VRE-positive. From 1,700 environment specimens, 110 VRE isolates were obtained from the inanimate environment, 5 from the living environment. Molecular biological typing identified 5 different clones which had spread on the ward in different locations.


CONCLUSIONS
The study shows the need for prophylactic microbiological screening investigations in the risk group of hematological oncology patients and consistent implementation of protective hygiene measures to prevent the spread of multiresistant infectious pathogens on risk wards. It is also shown that intervention can to control such an endemic outbreak.
Knoll
Martin
M
Institut für Hygiene, Martin-Luther-Universität Halle-Wittenberg, Germany. martin.knoll@medizin.uni-halle.de
Daeschlein
Georg
G
Okpara-Hofmann
Julia
J
Klare
Ingo
I
Wilhelms
Dorothea
D
Wolf
Hans-Heinrich
HH
Borneff-Lipp
Marianne
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data*; D016983:Enterococcus / Q000187:drug effects*; D005858:Germany / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008403:Mass Screening / Q000379:methods; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents