Vancomycin Resistant Enterococci outbreak in neonatal unit and management of cases after discharge

Abstract

Today, hospital infections with vancomycin resistant enterococci (VRE) in neonatal units have been seen with increasing frequency in recent yr. However, VRE colonized persons have greater risks for public health after discharge. We evaluated the risk factors in the prenatal and natal period of patients with VRE colonization and/or infection, as well as measures taken during VRE outbreak and after discharge occurring between the mo of February to April of 2009 in the Erciyes University, Neonatology Unit. VRE colonization and/or infection was detected in 26 (5.9%) of the 438 patients during time of outbreak. Enterococcus faecium was isolated in rectal swab cultures of all patients, and the type of glycopeptide resistance was VanA in all patients except one. Three of cases were term (11%), the remaining 23(89%) were preterm. E. faecium isolated from the blood culture in two patients. The history of mothers including prenatal risk factors and infant related risk factors were evaluated. The number of cases with VRE-positive was 15 (57%) on discharge and three of these patients were still colonized with VRE at re-hospitalization. The outbreak of VRE, experienced in our unit usually occurs in the manner of colonization. Prevention of colonization require reduction of the use of antibiotics in the perinatology and neonatology units, infection control measurements to be maximized.