Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital
INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We cond...
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Sociedade Brasileira de Medicina Tropical (SBMT)
2012
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Online Access: | https://doi.org/10.1590/S0037-86822012000200009 https://doaj.org/article/0b299b601e7b4b7d8669bdf5ce7e59b0 |
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ftdoajarticles:oai:doaj.org/article:0b299b601e7b4b7d8669bdf5ce7e59b0 2023-05-15T15:13:49+02:00 Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital Flávia Alves Ferreira Rossini Renata Fagnani Mirtes Loeschner Leichsenring Sônia Regina Perez Evangelista Dantas Luís Gustavo de Oliveira Cardoso Carlos Emílio Levy Maria Luiza Moretti Plínio Trabasso 2012-04-01T00:00:00Z https://doi.org/10.1590/S0037-86822012000200009 https://doaj.org/article/0b299b601e7b4b7d8669bdf5ce7e59b0 EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822012000200009&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/S0037-86822012000200009 https://doaj.org/article/0b299b601e7b4b7d8669bdf5ce7e59b0 Revista da Sociedade Brasileira de Medicina Tropical, Vol 45, Iss 2, Pp 184-188 (2012) Enterococcus Resistência à vancomicina Surtos Epidemiologia Controle de infecção Arctic medicine. Tropical medicine RC955-962 article 2012 ftdoajarticles https://doi.org/10.1590/S0037-86822012000200009 2022-12-31T03:06:27Z INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 45 2 184 188 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Enterococcus Resistência à vancomicina Surtos Epidemiologia Controle de infecção Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Enterococcus Resistência à vancomicina Surtos Epidemiologia Controle de infecção Arctic medicine. Tropical medicine RC955-962 Flávia Alves Ferreira Rossini Renata Fagnani Mirtes Loeschner Leichsenring Sônia Regina Perez Evangelista Dantas Luís Gustavo de Oliveira Cardoso Carlos Emílio Levy Maria Luiza Moretti Plínio Trabasso Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
topic_facet |
Enterococcus Resistência à vancomicina Surtos Epidemiologia Controle de infecção Arctic medicine. Tropical medicine RC955-962 |
description |
INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE. |
format |
Article in Journal/Newspaper |
author |
Flávia Alves Ferreira Rossini Renata Fagnani Mirtes Loeschner Leichsenring Sônia Regina Perez Evangelista Dantas Luís Gustavo de Oliveira Cardoso Carlos Emílio Levy Maria Luiza Moretti Plínio Trabasso |
author_facet |
Flávia Alves Ferreira Rossini Renata Fagnani Mirtes Loeschner Leichsenring Sônia Regina Perez Evangelista Dantas Luís Gustavo de Oliveira Cardoso Carlos Emílio Levy Maria Luiza Moretti Plínio Trabasso |
author_sort |
Flávia Alves Ferreira Rossini |
title |
Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
title_short |
Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
title_full |
Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
title_fullStr |
Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
title_full_unstemmed |
Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital |
title_sort |
successful prevention of the transmission of vancomycin-resistant enterococci in a brazilian public teaching hospital |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2012 |
url |
https://doi.org/10.1590/S0037-86822012000200009 https://doaj.org/article/0b299b601e7b4b7d8669bdf5ce7e59b0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 45, Iss 2, Pp 184-188 (2012) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822012000200009&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/S0037-86822012000200009 https://doaj.org/article/0b299b601e7b4b7d8669bdf5ce7e59b0 |
op_doi |
https://doi.org/10.1590/S0037-86822012000200009 |
container_title |
Revista da Sociedade Brasileira de Medicina Tropical |
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45 |
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2 |
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184 |
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188 |
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