Unprecedented nosocoimal spread os vancomycin-resistant Enterococcus faecium in a tertiary-care hospital in Switzerland

Results In November 2010, a first case of VRE was detected in a urine culture. The investigation identified 3 secondary cases in roommates (asymptomatic carriage). A second clinical case was detected in January 2011. Four secondary cases were identified. Both index cases were previously hospitalized in the same regional hospital. All patients transferred from the regional hospital were screened for VRE. In addition, weekly screening was initiated in patients hospitalized in the epidemic ward. In total, from November 2010 to March 2011, 31 VRE cases were identified: 4 in clinical specimens (urine 2, wound 2) and 27 in screening swabs. One patient presented a VRE bacteremia. Molecular analysis showed that all isolates except 2 had the same PFGE pattern. The 2 different strains had only a variation of 1 to 2 bands and were probably related to the outbreak. Infection control measures (contact isolation of carriers and roommates, quarantine of the epdiemic ward and reinforcement of environment disinfection) were implemented.