| Autor: |
Timmers, Gert Jan, van der Zwet, Wil C, Simoons-Smit, Ina M, Savelkoul, Paul H. M, Meester, Helena H. M, Vandenbroucke-Grauls, Christina M. J. E, Huijgens, Peter C |
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| Zdroj: |
British Journal of Haematology; Mar2002, Vol. 116 Issue 4, p826-833, 8p |
| Abstrakt: |
Summary. We describe an outbreak of vancomycin-resistant Enterococcus faecium (VRE) on the haematology ward of a Dutch university hospital. After the occurrence of three consecutive cases of bacteraemia with VRE, strains were genotyped and found to be identical. During the next 4 months an intensive surveillance programme identified 21 additional patients to be colonized with VRE, while two more patients developed bacteraemia. A case–control study was carried out to identify risk factors for VRE acquisition. In comparison with VRE-negative control patients (n =49), cases (n =24) had a longer stay on the ward during the year preceding the outbreak (25·8 versus 10·1 d, P =0·02), more cases with acute myeloid leukaemia [11 versus 4, odds ratio (OR) 9·5, 95% confidence interval (CI95 ) 2·4–32·2] and higher grades of mucositis (P =0·03). Logistic regression analysis identified antibiotic use within 1 month before admission (OR 13·0, CI95 2·1–80·5, P= 0·006) and low albumin levels at baseline (OR 1·2, CI95 1·1–1·3, P =0·02) to be independent risk factors. Four patients with VRE-bacteraemia were successfully treated with quinupristin/dalfopristin (Synercid® ). Control of the outbreak was achieved by step-wise implementation of intensive infection control measures, which included the cohorting of patients, allocation of nurses and reinforcement of hand hygiene. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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