Epidemiology of vancomycin-resistant enterococci in the Hradec Králové University Hospital in 2017

Česká verzia

Authors: P. Polcarová ¹; L. Hobzová ²; J. Smetana ¹ ; R. Šošovičková ³; R. Chlíbek ¹
Authors place of work: Katedra epidemiologie Fakulty vojenského zdravotnictví Univerzity obrany v Brně, Hradec Králové ¹; Oddělení nemocniční hygieny, Fakultní nemocnice Hradec Králové ²; Vojenský zdravotní ústav, Praha ³
Published in the journal: Epidemiol. Mikrobiol. Imunol. 69, 2020, č. 3, s. 107-115
Category: Original Papers

Summary

Vancomycin-resistant enterococci (VRE) have been a major public health concern for years. These pathogens are highly resistant, which facilitates their spread in health care settings where they may cause infections difficult to treat with antibiotics, particularly in immunocompromised patients. Over recent years, a considerable increase in VRE has also been observed in the Hradec Králové University Hospital. In 2017, 59 cases of VRE colonization or infection were newly diagnosed in inpatients. Based on a retrospective investigation, infected patients were identified, and from the hospital information system data, clinical and epidemiological factors possibly linked to VRE were analysed. It was concluded that one of the reasons behind the increase in VRE was poor compliance with the hygienic antiepidemic rules in general and with hand hygiene in particular, which was confirmed by the changed epidemiological situation the following year after more stringent rules were adopted. Raising awareness of health care workers about good practices to reduce the risk of the spread of resistant pathogens is crucial for the prevention of these infections.

Keywords:

surveillance – Epidemiology – vancomycin-resistant enterococci – antiepidemic measures

Zdroje

1. Vágnerová I, Kolář M. Možnosti terapie infekcí způsobených vankomycin-rezistentními enterokoky. Klin Farmakol Farm, 2003;17:170–173.

2. O’Driscoll T, Crank ChW. Vancomycin-resistant enterococcal infec-tions: epidemiology, clinical manifestations, and optimal management. Infect Drug Resist, 2015;8:217–230.

3. Miller WR, Munita JM, Arias CA. Mechanisms of antibiotic resistance in enterococci. Expert Rev Anti Infect Ther, 2014;12(10):1221–1236.

4. Kolář M. Problematika vankomycin-rezistentních enterokoků. Klin Mikrobiol Inf Lek, 2018;24(2):50–56.

5. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. Dostupné na www: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.

6. Talaga-Ćwiertnia K, Bulanda M. Analysis of the world epidemiological situation among vancomycin-resistant Enterococcus faecium infections and the current situation in Poland. Przegl epidemiol, 2018;72(1):3–15.

7. McDonald LC, Kuehnert MJ, Tenover FC, et al. Vancomycin-Resistant Enterococci Outside the Health-Care Setting: Prevalence, Sources, and Public Health Implications. Emerg Infect Dis, 1997;3(3):311–317.

8. European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe 2016. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net), 2017. Dostupné na www: https://www.ecdc.europa.eu/sites/portal/files/documents/AMR-surveillance-Europe-2016.pdf.

9. Gastmeier P, Schröder C, Behnke M, et al. Dramatic increase in vancomycin-resistant enterococci in Germany. J Antimicrob Chemother, 2014;69(6):1660–1664.

10. Werner G, Coque TM, Hammerum AM, et al. Emergence and spread of vancomycin resistance among enterococci in Europe. Euro Surveill, 2008;20;13(47)pii: 19046.

11. Bonten MJM, Willems R, Weinstein RA. Vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis, 2001;1:314–325.

12. Willems RJL, Top J, Braak van den N, et al. Host Specificity of Vancomycin-Resistant Enterococcus faecium. J Infect Dis, 2000;182(3):816–823.

13. Bortolaia V, Mander M, Jensen LB, et al. Persistence of vancomycin resistance in multiple clones of Enterococcus faecium isolated from Danish broilers 15 years after the ban of avoparcin. Antimicrob Agents Chemother, 2015;59(5):2926–2929.

14. Nilsson O, Greko C, Top J, et al. Spread without known selective pressure of a vancomycin-resistant clone of Enterococcus faecium among broilers. J Antimicrob Chemother, 2009;63(5):868–872.

15. Cetinkaya Z, Falk P, Mayhall CG. Vancomycin-Resistant Enterococci. Clin Microbiol Rev, 2000;13(4):686–707.

16. Harbarth S, Cosgrove S, Carmeli Y. Effects of Antibiotics on Nosocomial Epidemiology of Vancomycin-Resistant Enterococci. Antimicrob Agents Chemother, 2002;46(6)1619–1628.

17. Bonten MJM, Hayden MK, Nathan C, et al. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet, 1996;348:1615–1619.

18. Montecalvo MA, Lencastre H, Carraher M, et al. Natural History of Colonization with Vancomycin-Resistant Enterococcus Faecium. Infect Control Hosp Epidemiol, 1995; 16(12):680–685.

19. Tresoldi AT, Cardoso LGO, Castilho GV, et al. Low prevalence of vancomycin resistant enterococci colonization in intensive care patients in a Brazilian teaching hospital. Braz J Infect Dis, 2006;10(4):239–241.

20. Vágnerová I, Sauera P, Kolář M. Sources and pathways of spread of vancomycin-resistant enterococci in hemato-oncological patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2006;150(1):117–120.

21. Geldart KG, Kommineni S, Forbes M, et al. Engineered E. coli Nissle 1917 for the reduction of vancomycin-resistant Enterococcus in the intestinal tract. Bioeng Transl Med, 2018;3:197–208.

22. Zirakyadeh A, Patel R. Vancomycin-Resistant Enterococci: Colonization, Infection, Detection, and Treatment. Mayo Clin Proc, 2006;81(4):529–536.

23. Tornieporth NG, Roberts RB, John J, et al. Risk Factors Associated with Vancomycin-Resistant Enterococcus faecium Infection or Colonization in 145 Matched Case Patients and Control Patients. Clin Infect Dis, 1996; 23:767–772.

24. Zaas AK, Song X, Tucker P, et al. Risk Factors for Development of Vancomycin-Resistant Enterococcal Bloodstream Infection in Patients with Cancer Who Are Colonized with Vancomycin-Resistant Enterococci. Clin Infect Dis, 2002;35(10):1139–1146.

25. Moellering RC, Linden PK, Reinhardt J, et al. The efficacy and safety of quinupristin/dalfopristin for the treatment of infections caused by vancomycin-resistant Enterococcus faecium. J Antimicrob Chemother, 1999;44(2):251–261.

26. Monteserin N, Larson E. Temporal trends and risk factors for healthcare-associated vancomycin-resistant enterococci in adults. J Hosp Infect, 2016;94(3):236–241.

27. Filipovský J. Arteriální hypertenze ve stáří. Medicína po promoci, 2017. Dostupné na www: https://www.tribune.cz/clanek/41935-arterialni-hypertenze-ve-stari.

28. Simner PJ, Adam H, Baxter M, et al. Epidemiology of vancomycin-resistant enterococci in Canadian hospitals (CANWARD study, 2007 to 2013). Antimicrob Agents Chemother, 2015;59(7):4315–4317.

29. Joels CS, Matthews BD, Sigmon LB, et al. Clinical characteristics and outcomes of surgical patients with vancomycin-resistant enterococcal infections. Am Surg, 2003;69(6):514–519.

30. Karki S, Land G, Aitchison S, et al. Long-term carriage of vancomycin-resistant enterococci in patients discharged from hospitals: a 12-year retrospective cohort study. J Clin Microbiol, 2013;51(10):3374–3379.

31. Wendt C, Krause C, Xander LU, et al. Prevalence of colonization with vancomycin-resistant enterococci in various population groups in Berlin, Germany. J Hosp Infect, 1999;42:193–200.

32. Louisiana Office of Public Health – Infectious Disease Epidemiology Section. Vancomycin Resistant Enterococcus (VRE). Annual Report, 2016. Dostupné na www: http://ldh.la.gov/assets/oph/Center-PHCH/Center-CH/infectious-epi/Annuals/VRE_LaIDAnnual.pdf.

33. Kampmeier S, Kossow A, Clausen LM, et al. Hospital acquired vancomycin resistant enterococci in surgical intensive care patients – a prospective longitudinal study. Antimicrob Resist Infect Control, 2008;7:103.

34. Mazuski JE. Vancomycin-resistant Enterococcus: Risk factors, surveillance, infections, and treatment. Surg Infect, 2008;9(6):567–571.

35. Rice LB. Emergence of Vancomycin-Resistant Enterococci. Emerg Infect Dis, 2001;7(2):183–187.

36. SZÚ. Databáze výsledků EARS-Net [online]. 2010. Dostupné na www: https://apps.szu.cz/earsnet/uvod.php.

37. Deshpande LM, Fritsche TR, Moet GJ, et al. Antimicrobial resistence and molecular epidemiology of vancomycin-resistant enterococci from North America and Europe: a report from the SENTRY antimicrobial surveillance program. Diagn Microbiol Infect Dis, 2007; 58:163–170.

38. Morris-Downes M, Smyth EG, Moore J, et al. Surveillance and endemic vancomycin-resistant enterococci: some succes in control is possible. J Hosp Infect, 2010;75:228–233.

39. Wells CL, Juni BA, Cameron SB, et al. Stool Carriage, Clinical Isolation, and Mortality During an Outbreak of Vancomycin-Resistant Enterococci in Hospitalized Medical and/or Surgical Patients. Clin Infect Dis, 1995; 21(1):45–50.

40. Kramer TS, Remschmidt C, Werner S, et al. The importance of adjusting for enterococcus species when assessing the burden of vancomycin resistance: a cohort study including over 1000 cases of enterococcal bloodstream infections. Antimicrob Resist Infect Control, 2018; 7:133.

41. Blanco N, Perencevich E, Li SS, et al. Effect of meteorological factors and geografic location on methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization in the US. PLoS One, 2017;12(5): e0178254.

42. Neely AN, Maley MP. Survival of Enterococci and Staphylococci on Hospital Fabrics and Plastic. J Clin Microbiol, 2000;38(2):724–726.

43. Boyce JM, Opal SM, Chow JW, et al. Outbreak of Multidrug-Resistant Enterococcus faecium with Transferable vanB Class Vancomycin Resistance. J Clin Microbiol, 1994; 32(5):1148–1153.

44. Ostrowsky BE, Trick WE, Sohn AH, et al. Control of vancomycin-resistant enterococcus in health care facilities in a region. N Engl J Med, 2001; 344(19):1427–1433.

45. Chang S, Sievert DM, Hageman JC, et al. Infection with Vancomycin-Resistant Staphylococcus aureus Containing the vanA Resistance Gene. N Engl J Med, 2003;348:1342–1347.

46. Greene MH, Harris BD, Nesbitt WJ, et al. Risk Factors and Outcomes Associated With Acquisition of Daptomycin and Linezolid–Nonsusceptible Vancomycin-Resistant Enterococcus. Open Forum Infect Dis, 2018;5(10):ofy185.

47. McKinnell JA, Kunz DF, Chamot E, et al. Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage. Infect Control Hosp Epidemiol, 2012;33(7):718–724.

48. Anglim, AM, Klym B, Byers KE, et al. Effect of a Vancomycin Restriction Policy on Ordering Practices During an Outbreak of Vancomycin-Resistant Enterococcus faecium. Arch Intern Med, 1997;157(10):1132–1136.

49. de Bruin MA, Riley LW. Does vancomycin prescribing intervention affect vancomycin-resistant enterococcus infection and colonization in hospitals? A systematic review. BMC Infect Dis, 2007;7:24.

50. Cheah ALY, Cheng AC, Spelman D, et al. Mathematical modelling of vancomycin-resistant enterococci transmission during passive surveillance and active surveillance with contact isolation highlights the need to identify and address the source of acquisition. BMC Infect Dis, 2018;18(1):511.

51. Vehreschild MJGT, Haverkamp M, Biehl LM, et al. Vancomycin-resistant enterococci (VRE): a reason to isolate? Infection, 2019;47(1):7–11.