title: [Environmental contamination during a vancomycin-resistant Enterococci outbreak at a hospital in Argentina].
abstract: BACKGROUND
  Vancomycin-resistant enterococci isolates (VRE) have caused numerous outbreaks in intensive care units (ICUs). A contaminated hospital environment, the hands of health care workers (HCW), and carrier patients may play important roles in perpetuating the chain of transmission in these outbreaks. The aims of this study were to report the first VRE outbreak in our center and assess the role of environmental contamination and HCW hands in the spread of new cases of enterococcal infection.
  
  
  METHODS
  Between August and December 2003, surveillance cultures were performed with samples from all patients (n = 113) admitted to the ICU, as well as cultures of samples from the environment (n = 69) and HCW hands (n = 23).
  
  
  RESULTS
  Eighteen clinical samples from 8 patients and 7 environmental samples yielded Enterococcus faecium (24 strains) and E. avium (1 strain). VRE was not detected on HCW hands. All the VRE isolates belonged to a single clone and carried the vanA gene.
  
  
  CONCLUSIONS
  Environmental contamination provides an important reservoir for future outbreaks of VRE, perpetuating transmission of the microorganism in the hospital setting.
authors.affiliation: Laboratorio de Bacteriología, Micología y Parasitología. Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC). Capital Federal. Buenos Aires. Argentina. sole_z@hotmail.com
authors.forename: Mariela Soledad
authors.initials: MS
authors.lastname: Zárate
authors.forename: Ana
authors.initials: A
authors.lastname: Gales
authors.forename: Liliana
authors.initials: L
authors.lastname: Jordá-Vargas
authors.forename: Diego
authors.initials: D
authors.lastname: Yahni
authors.forename: Silvia
authors.initials: S
authors.lastname: Relloso
authors.forename: Pablo
authors.initials: P
authors.lastname: Bonvehi
authors.forename: Jussimara
authors.initials: J
authors.lastname: Monteiro
authors.forename: Antonio
authors.initials: A
authors.lastname: Campos-Pignatari
authors.forename: Jorgelina
authors.initials: J
authors.lastname: Smayevsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D001426:Bacterial Proteins / Q000032:analysis; D019729:Carbon-Oxygen Ligases / Q000032:analysis; D002999:Clone Cells; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D004196:Disease Outbreaks / Q000517:prevention & control; D004197:Disease Reservoirs; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D016984:Enterococcus faecium / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000472:pathogenicity*; D004866:Equipment Contamination; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D006225:Hand / Q000382:microbiology; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000592:standards; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital; D020713:Vancomycin Resistance / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; D019729:Carbon-Oxygen Ligases