Rapid control of an outbreak of vancomycin-resistant enterococci in a French university hospital

Lucet, Jean‐Christophe; Armand-Lefèvre, Laurence; Laurichesse, J J; Macrez, A.; Papy, Emmanuelle; Ruimy, Raymond; Deblangy, Claude; Lozach, A.; Lolom, Isabelle; Jarlier, Vincent; Andremont, Antoine; Leport, Catherine

doi:10.1016/j.jhin.2007.06.009

Cited by 52 publications

(17 citation statements)

References 17 publications

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“…ancomycin-resistant enterococci (VRE) are among the major nosocomial pathogens worldwide (1)(2)(3)(4). Animals, especially livestock, such as chickens and pigs, have consistently been reported as the reservoirs for VRE, due to the isolation of bacteria having similar genetic resistance characteristics to those strains found in humans (5)(6)(7)(8)(9).…”

mentioning

confidence: 99%

Genetic Variability of Vancomycin-Resistant Enterococcus faecium and Enterococcus faecalis Isolates from Humans, Chickens, and Pigs in Malaysia

Getachew

Hassan

Zakaria

et al. 2013

Appl Environ Microbiol

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Vancomycin-resistant enterococci (VRE) have been reported to be present in humans, chickens, and pigs in Malaysia. In the present study, representative samples of VRE isolated from these populations were examined for similarities and differences by using the multilocus sequence typing (MLST) method. Housekeeping genes of Enterococcus faecium (n ‫؍‬ 14) and Enterococcus faecalis (n ‫؍‬ 11) isolates were sequenced and analyzed using the MLST databases eBURST and goeBURST. We found five sequence types (STs) of E. faecium and six STs of E. faecalis existing in Malaysia. Enterococcus faecium isolates belonging to ST203, ST17, ST55, ST79, and ST29 were identified, and E. faecium ST203 was the most common among humans. The MLST profiles of E. faecium from humans in this study were similar to the globally reported nosocomial-related strain lineage belonging to clonal complex 17 (CC17). Isolates from chickens and pigs have few similarities to those from humans, except for one isolate from a chicken, which was identified as ST203. E. faecalis isolates were more diverse and were identified as ST4, ST6, ST87, ST108, ST274, and ST244, which were grouped as specific to the three hosts. E. faecalis, belonging to the high-risk CC2 and CC87, were detected among isolates from humans. In conclusion, even though one isolate from a chicken was found clonal to that of humans, the MLST analysis of E. faecium and E. faecalis supports the findings of others who suggest VRE to be predominantly host specific and that clinically important strains are found mainly among humans. The infrequent detection of a human VRE clone in a chicken may in fact suggest a reverse transmission of VRE from humans to animals.

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confidence: 99%

Genetic Variability of Vancomycin-Resistant Enterococcus faecium and Enterococcus faecalis Isolates from Humans, Chickens, and Pigs in Malaysia

Getachew

Hassan

Zakaria

et al. 2013

Appl Environ Microbiol

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“…Previous studies have demonstrated the benefit of active surveillance cultures to control VRE transmission in hospitals, however, these were generally done during an outbreak in which multiple interventions were introduced simultaneously (10,11). We found that discontinuation of reflex VRE testing of stool submitted for testing for C. difficile resulted in an approximately 71% increase in the endemic healthcare-associated VRE rate.…”

Section: Resultsmentioning

confidence: 74%

Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

McMullen

Bodily²,

Russo³

et al. 2012

American Journal of Infection Control

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“…Most hospitals, often due to the lack of routine active surveillance, do not identify a large proportion of colonized patients who are potential sources for ongoing hospital transmission (5, 6). Some studies have demonstrated the benefit of active surveillance cultures to control VRE transmission in hospitals; however, these were generally done during an outbreak in which multiple interventions were introduced simultaneously (7, 8). In our previous study, we found that discontinuation of reflex VRE testing of stool submitted for testing for C. difficile at our hospital resulted in a 71% increase in the endemic healthcare-associated VRE rate (Figure).…”

Section: Resultsmentioning

confidence: 99%

Reinstatement of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci (VRE) Resulted in Decreased Incidence of Hospital-Associated VRE

Munigala

McMullen²,

Russo

et al. 2017

Infect. Control Hosp. Epidemiol.

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Rapid control of an outbreak of vancomycin-resistant enterococci in a French university hospital

Cited by 52 publications

References 17 publications

Genetic Variability of Vancomycin-Resistant Enterococcus faecium and Enterococcus faecalis Isolates from Humans, Chickens, and Pigs in Malaysia

Genetic Variability of Vancomycin-Resistant Enterococcus faecium and Enterococcus faecalis Isolates from Humans, Chickens, and Pigs in Malaysia

Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

Reinstatement of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci (VRE) Resulted in Decreased Incidence of Hospital-Associated VRE

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