title: Outbreak of vancomycin-resistant enterococci in a tertiary hospital: the lack of effect of measures directed mainly by surveillance cultures and differences in response between Enterococcus faecium and Enterococcus faecalis.
abstract: To describe the effect of active surveillance to control vancomycin-resistant enterococci (VRE) after an outbreak, 549 surveillance rectal cultures were performed in 308 patients (35% positive). An educational intervention to prevent transmission was implemented. Infection and colonization by VR- Enterococcus faecalis decreased, but Enterococcus faecium persisted despite control measures. Infections by VR-E faecalis fell to zero in 2008. We observed difficulties in controlling colonization with measures directed mainly by surveillance cultures and differences between responses of E faecium and E faecalis.
authors.affiliation: Infection Control Department of Hospital Brigadeiro of São Paulo, São Paulo, Brazil.
authors.forename: Graziella H
authors.initials: GH
authors.lastname: Pereira
authors.forename: Patrícia R
authors.initials: PR
authors.lastname: Müller
authors.forename: Rosemeire C
authors.initials: RC
authors.lastname: Zanella
authors.forename: Marisa
authors.initials: M
authors.lastname: de Jesus Castro Lima
authors.forename: Dionisio Setaro
authors.initials: DS
authors.lastname: Torchio
authors.forename: Anna S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004196:Disease Outbreaks / Q000517:prevention & control*; D004203:Disinfection; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects* / Q000302:isolation & purification; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005243:Feces / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006235:Hand Disinfection; D006779:Hospitals, Public; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008826:Microbial Sensitivity Tests; D010356:Patient Isolation; D011159:Population Surveillance; D055512:Tertiary Prevention; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin