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. 2022 Dec;27(48):2200285.
doi: 10.2807/1560-7917.ES.2022.27.48.2200285.

Nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VRE) ST796, Switzerland, 2017 to 2020

Vanja Piezzi  1 , Nasstasja Wassilew  1 , Andrew Atkinson  1 , Stéphanie D'Incau  2 , Tanja Kaspar  1 , Helena Mb Seth-Smith  3   4 , Carlo Casanova  5 , Pascal Bittel  5 , Philipp Jent  1 , Rami Sommerstein  6   1 , Niccolò Buetti  7   8 , Jonas Marschall  9   1
Affiliations

Nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VRE) ST796, Switzerland, 2017 to 2020

Vanja Piezzi et al. Euro Surveill. 2022 Dec.

Abstract

A large clonal outbreak caused by vancomycin-resistant Enterococcus faecium (VRE) affected the Bern University Hospital group from the end of December 2017 until July 2020. We describe the characteristics of the outbreak and the bundle of infection prevention and control (IPC) measures implemented. The outbreak was first recognised when two concomitant cases of VRE bloodstream infection were identified on the oncology ward. During 32 months, 518 patients in the 1,300-bed hospital group were identified as vanB VRE carriers. Eighteen (3.5%) patients developed an invasive infection, of whom seven had bacteraemia. In 2018, a subset of 328 isolates were analysed by whole genome sequencing, 312 of which were identified as sequence type (ST) 796. The initial IPC measures were implemented with a focus on the affected wards. However, in June 2018, ST796 caused another increase in cases, and the management strategy was intensified and escalated to a hospital-wide level. The clinical impact of this large nosocomial VRE outbreak with the emergent clone ST796 was modest. A hospital-wide approach with a multimodal IPC bundle was successful against this highly transmissible strain.

Keywords: VRE; Vancomycin resistant Enterococcus faecium; Whole genome sequencing; antibiotic resistance; infection prevention and control; nosocomial outbreak; outbreak management.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Epidemic curve of VRE detections (n =518) and screening volume (n = 27,725), Bern University Hospital Group, Bern, Switzerland, December 2017–July 2020
See this image and copyright information in PMC

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