法国成功控制一起医院内万古霉素耐药的屎肠球菌暴发感染

David

Eur J Clin Microbiol Infect Dis. 2008 Jul 9. [Epub ahead of print] Links
Successful control of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in France.
法国成功控制一起医院内万古霉素耐药的屎肠球菌暴发感染
Aumeran C, Baud O, Lesens O, Delmas J, Souweine B, Traoré O.
Université Clermont1, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

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.

David

e 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. (我们成功控制了一起医院范围内VRE暴发感染的事件，发生在法国Clermont-Ferrand一家有2000张床位的医院三个不同的院区内。)From January 2004 to April 2007, 220 VRE cases were identified. （从04年1月至07年4月，共分离鉴定出220株VRE!!!!:L 这家院长肯定彻底崩溃了，谁还敢住进来啊~~:funk: ）Overall, 28 different wards had at least one case. （总体上，28个不同的病区至少有1例感染。）All of the strains expressed a high level of resistance to vancomycin and to teicoplanin carried by the vanA gene. （所有的菌株都对万古霉素和替考拉宁高水平耐药，并携带vanA基因。）Pulsed-field gel electrophoresis (PFGE) analysis of the strains revealed that they were clonally related. （PFGE显示它们均为克隆相关。）Control measures consisted of implementing a strategy of VRE screening by rectal swab, reinforcing hand hygiene practices and taking contact precautions. （控制措施包括用直肠肛拭子筛查VRE，加强手卫生和实行接触隔离。）Recommendations for a restricted use of specific antibiotics were sent to each physician. （推荐每个医生限制某些特定的抗生素使用。）Alcohol-based handrubs were provided throughout the hospital and the staff underwent training for their use. （酒精擦手液提供给全院范围使用，重新培训医护人员正确使用酒精擦手液。）Compliance with contact precautions, including the use of clean non-sterile gloves and single-use gowns, was reinforced. （接触隔离的配套措施包括：强化一次性无菌手套的使用。）VRE cases were assigned systematically to a single-bed room. （VRE携带者都安置于单人间。）In October 2007, no new VRE carriage has been detected for 7 months and no clinical samples had been VRE-positive for 10 months. （截至07年10月，7个月内未检测到新发VRE携带者，10个月没有VRE阳性标本被发现。）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.（结论，一起医院范围内的VRE暴发感染被成功控制。策略包括常规筛查，强化手卫生，实行接触隔离。）