Artículos de revistas
Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention
Fecha
2012Registro en:
BRAZILIAN JOURNAL OF MEDICAL AND BIOLOGICAL RESEARCH, SAO PAULO, v. 45, n. 2, supl., Part 3, pp. 158-162, FEB, 2012
0100-879X
10.1590/S0100-879X2012007500005
Autor
Carmona, F.
Prado, S. I.
Silva, M. F. I.
Gaspar, G. G.
Bellissimo-Rodrigues, F.
Martinez, R.
Matsuno, A. K.
Carlotti, A. P. C. P.
Institución
Resumen
The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.