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Successful control of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in France

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Abstract

We describe the control of a hospital-wide vancomycin-resistant Enterococcus faecium (VRE) outbreak in a 2,000-bed university hospital located on three different sites in Clermont-Ferrand, France. From January 2004 to April 2007, 220 VRE cases were identified. Overall, 28 different wards had at least one case. All of the strains expressed a high level of resistance to vancomycin and to teicoplanin carried by the vanA gene. Pulsed-field gel electrophoresis (PFGE) analysis of the strains revealed that they were clonally related. Control measures consisted of implementing a strategy of VRE screening by rectal swab, reinforcing hand hygiene practices and taking contact precautions. Recommendations for a restricted use of specific antibiotics were sent to each physician. Alcohol-based handrubs were provided throughout the hospital and the staff underwent training for their use. Compliance with contact precautions, including the use of clean non-sterile gloves and single-use gowns, was reinforced. VRE cases were assigned systematically to a single-bed room. In October 2007, no new VRE carriage has been detected for 7 months and no clinical samples had been VRE-positive for 10 months. In conclusion, a hospital-wide VRE outbreak was successfully controlled by a strategy based on routine screening, the reinforcement of hand hygiene and taking barrier precautions.

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Authors and Affiliations

  1. Université Clermont1, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France

    C. Aumeran, O. Baud & O. Traoré

  2. Service d’Hygiène Hospitalière, Centre Hospitalier Universitaire de Clermont-Ferrand, Rue Montalembert, 63000, Clermont-Ferrand, France

    C. Aumeran & O. Traoré

  3. Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France

    O. Lesens

  4. Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France

    J. Delmas

  5. CLIN, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France

    B. Souweine

Authors
  1. C. Aumeran
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  2. O. Baud
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  3. O. Lesens
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  4. J. Delmas
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  5. B. Souweine
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  6. O. Traoré
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Corresponding author

Correspondence to O. Traoré.

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Aumeran, C., Baud, O., Lesens, O. et al. Successful control of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in France. Eur J Clin Microbiol Infect Dis 27, 1061–1064 (2008). https://doi.org/10.1007/s10096-008-0544-0

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  • DOI: https://doi.org/10.1007/s10096-008-0544-0

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