Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review
Background: Vancomycin-resistance in Enterococcus faecium (VRE) poses a major threat in health care settings. It is well known that patients in hematology and oncology departments are especially at risk of nosocomial VRE acquisition. This systematic review of the literature provides data on the main...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-12-01
|
| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S240584401731527X |
| _version_ | 1818985301606924288 |
|---|---|
| author | Nikos Ulrich Ralf-Peter Vonberg Petra Gastmeier |
| author_facet | Nikos Ulrich Ralf-Peter Vonberg Petra Gastmeier |
| author_sort | Nikos Ulrich |
| collection | DOAJ |
| description | Background: Vancomycin-resistance in Enterococcus faecium (VRE) poses a major threat in health care settings. It is well known that patients in hematology and oncology departments are especially at risk of nosocomial VRE acquisition. This systematic review of the literature provides data on the main sources, transmission modes and potential risk factors for VRE acquisition as well as appropriate infection control measures in order to terminate such nosocomial outbreaks.
Methods: Data on nosocomial VRE outbreaks on hematology and oncology wards was retrieved from the Outbreak Database and PubMed.
Results: A total of 35 VRE outbreaks describing 757 affected patients and 77 deaths were included in this review. The most frequent site of pathogen detection were stool samples or rectal swabs (57% of all isolation sites), followed by blood cultures (30%). The most common outbreak source was an index patient. The main modes of transmission were 1) hands of health care workers, 2) contact to a contaminated environment and 3) patient-to-patient contact. The most common risk factor for VRE positivity was prior antibiotic treatment. The most common infection control measures performed were screening and isolating or cohorting of patients.
Conclusion: A rational use of antibiotics in hematology and oncology units is recommended in order to reduce selection pressure on resistant pathogens such as VRE. In addition the importance of hand hygiene should be stressed to all staff whenever possible. |
| first_indexed | 2024-12-20T18:32:44Z |
| format | Article |
| id | doaj.art-794575fe435a404697eef8fb3569036c |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-20T18:32:44Z |
| publishDate | 2017-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-794575fe435a404697eef8fb3569036c2022-12-21T19:30:00ZengElsevierHeliyon2405-84402017-12-0131210.1016/j.heliyon.2017.e00473Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic reviewNikos Ulrich0Ralf-Peter Vonberg1Petra Gastmeier2Charité – Institute for Hygiene and Environmental Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, 12203 Berlin, GermanyInstitute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, GermanyCharité – Institute for Hygiene and Environmental Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, 12203 Berlin, GermanyBackground: Vancomycin-resistance in Enterococcus faecium (VRE) poses a major threat in health care settings. It is well known that patients in hematology and oncology departments are especially at risk of nosocomial VRE acquisition. This systematic review of the literature provides data on the main sources, transmission modes and potential risk factors for VRE acquisition as well as appropriate infection control measures in order to terminate such nosocomial outbreaks. Methods: Data on nosocomial VRE outbreaks on hematology and oncology wards was retrieved from the Outbreak Database and PubMed. Results: A total of 35 VRE outbreaks describing 757 affected patients and 77 deaths were included in this review. The most frequent site of pathogen detection were stool samples or rectal swabs (57% of all isolation sites), followed by blood cultures (30%). The most common outbreak source was an index patient. The main modes of transmission were 1) hands of health care workers, 2) contact to a contaminated environment and 3) patient-to-patient contact. The most common risk factor for VRE positivity was prior antibiotic treatment. The most common infection control measures performed were screening and isolating or cohorting of patients. Conclusion: A rational use of antibiotics in hematology and oncology units is recommended in order to reduce selection pressure on resistant pathogens such as VRE. In addition the importance of hand hygiene should be stressed to all staff whenever possible.http://www.sciencedirect.com/science/article/pii/S240584401731527XInfectious diseaseMedicineInternal medicineOncology |
| spellingShingle | Nikos Ulrich Ralf-Peter Vonberg Petra Gastmeier Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review Heliyon Infectious disease Medicine Internal medicine Oncology |
| title | Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review |
| title_full | Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review |
| title_fullStr | Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review |
| title_full_unstemmed | Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review |
| title_short | Outbreaks caused by vancomycin-resistant Enterococcus faecium in hematology and oncology departments: A systematic review |
| title_sort | outbreaks caused by vancomycin resistant enterococcus faecium in hematology and oncology departments a systematic review |
| topic | Infectious disease Medicine Internal medicine Oncology |
| url | http://www.sciencedirect.com/science/article/pii/S240584401731527X |
| work_keys_str_mv | AT nikosulrich outbreakscausedbyvancomycinresistantenterococcusfaeciuminhematologyandoncologydepartmentsasystematicreview AT ralfpetervonberg outbreakscausedbyvancomycinresistantenterococcusfaeciuminhematologyandoncologydepartmentsasystematicreview AT petragastmeier outbreakscausedbyvancomycinresistantenterococcusfaeciuminhematologyandoncologydepartmentsasystematicreview |