Suivi prospectif de patients excréteurs d’entérocoques résistants aux glycopeptides en unité de soins de longue durée et efficacité des mesures de précaution « contact »

Abstract

Vancomycin-resistant enterococci (VRE) are major nosocomial pathogens in many countries. VRE can spread rapidly, mostly by cross-transmission through hands of healthcare workers, leading to outbreaks. Moreover, VRE have the possibility to transfer vancomycin resistance genes to other Gram-positive organisms. We conducted a 9-month prospective study to demonstrate the effectiveness of "contact" precautions to prevent the spread of VRE in a long-term care facility. Six patients with VRE colonisation were admitted in an 80-bed long-term care facility. The following interventions were implemented to prevent the spread of VRE: gathering patients with VRE colonisation in the same unit, reinforcement of hand hygiene practices, "contact" precautions, reduction of some antibiotics and extensive screening of VRE carriers and contact patients by rectal swabs. There was no secondary case of VRE colonisation. Screening tests converted from positive to negative in four of the six patients. Compliance with hand hygiene recommendations and "contact" precautions can prevent the spread of VRE in a long-term care facility.