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Article: Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region

TitleSuccessful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region
Authors
Issue Date2009
PublisherCo-Action Publishing. The Journal's web site is located at http://www.eht-journal.net/index.php/ehtj
Citation
Emerging Health Threats Journal, 2009, v. 2 article no. e9 How to Cite?
AbstractVancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P¼0.047), presence of nasogastric tubing (P¼0.002) and tracheostomy (Po0.001), and the use of b-lactam antibiotics (Po0.001) and vancomycin (P¼0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients’ immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.
Persistent Identifierhttp://hdl.handle.net/10722/143375
ISSN
2015 SCImago Journal Rankings: 1.033
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorCheng, VCCen_US
dc.contributor.authorChan, JFWen_US
dc.contributor.authorTai, JWMen_US
dc.contributor.authorHo, YYen_US
dc.contributor.authorLi, IWSen_US
dc.contributor.authorTo, KKWen_US
dc.contributor.authorHo, PLen_US
dc.contributor.authorYuen, KYen_US
dc.date.accessioned2011-11-24T10:04:20Z-
dc.date.available2011-11-24T10:04:20Z-
dc.date.issued2009en_US
dc.identifier.citationEmerging Health Threats Journal, 2009, v. 2 article no. e9en_US
dc.identifier.issn1752-8550en_US
dc.identifier.urihttp://hdl.handle.net/10722/143375-
dc.description.abstractVancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P¼0.047), presence of nasogastric tubing (P¼0.002) and tracheostomy (Po0.001), and the use of b-lactam antibiotics (Po0.001) and vancomycin (P¼0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients’ immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.-
dc.languageengen_US
dc.publisherCo-Action Publishing. The Journal's web site is located at http://www.eht-journal.net/index.php/ehtjen_US
dc.relation.ispartofEmerging Health Threats Journalen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleSuccessful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic regionen_US
dc.typeArticleen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1752-8550&volume=2 article no. e9&spage=&epage=&date=2009&atitle=Successful+control+of+vancomycin-resistant+Enterococcus+faecium+outbreak+in+a+neurosurgical+unit+at+non-endemic+regionen_US
dc.identifier.emailCheng, VCC: vcccheng@hkucc.hku.hken_US
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hken_US
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_US
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_US
dc.identifier.authorityTo, KKW=rp01384en_US
dc.identifier.authorityHo, PL=rp00406en_US
dc.identifier.authorityYuen, KY=rp00366en_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3134/ehtj.09.009-
dc.identifier.pmid22460290-
dc.identifier.pmcidPMC3167649-
dc.identifier.hkuros197698en_US
dc.identifier.volume2en_US

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