title: [Outbreak of vancomycin-resistant enterococci in a surgical intensive care unit].
abstract: BACKGROUND
  Enterococci have increasing importance in intensive care units, and vancomycin-resistant strains express a new challenge.
  
  
  OBJECTIVE
  The aim of the authors was to present their findings obtained from the first vancomycin-resistant enterococci outbreak occurred in 2013 at the Intensive Care Unit of the 1st Department of Surgery, Semmelweis University.
  
  
  METHODS
  This was a case-control study of patients who had Enterococci species isolated from their microbiological samples between January 1 and June 30, 2013. Changes of Enterococcal incidence and consequences of vancomycin-resistance in patient outcome were analyzed. Demographic data, hospital length of stay and mortality data were also collected.
  
  
  RESULTS
  Enterococci were isolated from 114 patients and 14 of them had vancomycin-resistant strains. The incidence of Enterococcal strains was not different in the periods before and after the outbreak of the first vancomycin-resistant Enterococci. Patients with vancomycin-resistant Enterococci had significantly higher mortality rate than those with vancomycin-sensitive Enterococcus (42.9% vs 30.0%, p = 0.005); however, length of stay was not significantly different. Co-morbidities and emergency surgery were significantly higher in patients who had vancomycin-resistant Enterococci.
  
  
  CONCLUSIONS
  The higher mortality observed in patients with vancomycin-resistant Enterococcus infections highlights the importance of prevention and appropriate infection control, however, the direct relationship of vancomycin-resistance and increased mortality is questionable.
authors.affiliation: I. Sebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Semmelweis Egyetem, Általános Orvostudományi Kar.
authors.forename: Marcell
authors.initials: M
authors.lastname: Szabó
authors.forename: Anna
authors.initials: A
authors.lastname: Bozó
authors.forename: Sándor
authors.initials: S
authors.lastname: Soós
authors.forename: Katalin
authors.initials: K
authors.lastname: Darvas
authors.forename: László
authors.initials: L
authors.lastname: Harsányi
authors.forename: Ákos
authors.initials: Á
authors.lastname: Csomós
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D004196:Disease Outbreaks; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012621:Seasons; D012720:Severity of Illness Index; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification
keywords: Enterococcus; enterococcus; intensive care; intenzív; sebészet; surgery; vancomycin; vancomycin-resistant enterococcus; vancomycinrezisztens Enterococcus