Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/199980
Type: Artigo de periódico
Title: Successful Prevention Of The Transmission Of Vancomycin-resistant Enterococci In A Brazilian Public Teaching Hospital.
Author: Rossini, Flávia Alves Ferreira
Fagnani, Renata
Leichsenring, Mirtes Loeschner
Dantas, Sônia Regina Perez Evangelista
Cardoso, Luís Gustavo de Oliveira
Levy, Carlos Emílio
Moretti, Maria Luiza
Trabasso, Plínio
Abstract: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe the epidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE.
Subject: Adolescent
Adult
Aged
Aged, 80 And Over
Brazil
Child
Cross Infection
Female
Hospitals, University
Humans
Infection Control
Male
Middle Aged
Program Evaluation
Retrospective Studies
Risk Factors
Vancomycin Resistance
Young Adult
Rights: aberto
Identifier DOI: 
Address: http://www.ncbi.nlm.nih.gov/pubmed/22534989
Date Issue: -1-Uns- -1
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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