Control measures for a VRE outbreak in a haemodialysis unit

• Published in: Néphrologie & thérapeutique Vol. 5 Suppl 4; pp. S272 - S280
• Main Authors: Diguio, N, Chanet, P, Hautemanière, A, Cao-Huu, T, Hartemann, P, Kessler, M
• Format: Journal Article
• Language: French
• Published: France 01.06.2009
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Carrier State - prevention & control; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Disease Outbreaks - prevention & control; Disinfection - methods; Enterococcus faecium - isolation & purification; Equipment Contamination - prevention & control; France; Gram-Positive Bacterial Infections - complications; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - prevention & control; Hemodialysis Units, Hospital; Humans; Patient Isolation; Protective Clothing; Retrospective Studies; Vancomycin - pharmacology; Vancomycin - therapeutic use; Vancomycin Resistance; France
• ISSN: 1769-7255; 1872-9177
• DOI: 10.1016/S1769-7255(09)74558-4

We report an outbreak of colonization with Vancomycin Resistant Enterococci (VRE) in the Haemodialysis unit of our hospital. From October 2004 to September 2008, 19 patients were found positive. The risk of acquiring this multi-resistant bacterium is extremely important in patients undergoing haemodialysis, heightened measures have gradually been set to control cross transmissions: first isolation, then geographic clustering of carriers and finally creating cohorting sectors with different staff for carriers, contacts and VRE free patients. This re-organization was supplemented by strengthening procedures for hand hygiene, active screening of patients and enhanced cleaning. Monitoring of the epidemic curve has allowed us to demonstrate the effectiveness of measures introduced. However, deleterious effects were observed in patients whose habits were changed; we could also highlight significant impact on the activity of the unit.