Giuseppe
Emeritus
[Source: Eurosurveillance, full text: (LINK). Abstract, edited.]
S Fournier (
)<SUP>1</SUP>, F Brossier<SUP>2</SUP>, N Fortineau<SUP>3</SUP>, F Gillaizeau<SUP>4</SUP>, A Akpabie<SUP>5</SUP>, A Aubry<SUP>6</SUP>, F Barbut<SUP>7</SUP>, F X Chedhomme<SUP>8</SUP>, N Kassis-Chikhani<SUP>9</SUP>, J C Lucet<SUP>10</SUP>, J Robert<SUP>2</SUP>, D Seytre<SUP>11</SUP>, I Simon<SUP>12</SUP>, D Vanjak<SUP>13</SUP>, J R Zahar<SUP>14</SUP>, C Brun-Buisson<SUP>15</SUP>, V Jarlier<SUP>1</SUP><SUP>,2</SUP>
Citation style for this article: Fournier S, Brossier F, Fortineau N, Gillaizeau F, Akpabie A, Aubry A, Barbut F, Chedhomme FX, Kassis-Chikhani N, Lucet JC, Robert J, Seytre D, Simon I, Vanjak D, Zahar JR, Brun-Buisson C, Jarlier V. Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a large multihospital institution: a seven-year experience. Euro Surveill. 2012;17(30)
ii=20229. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20229
Date of submission: <HR>Repeated outbreaks of vancomycin-resistant Enterococcus faecium (VRE) occurred between 2004 and 2010 in Assistance Publique ? H?pitaux de Paris (AP-HP), a 23,000-bed multi-hospital institution. From August 2004 to December 2005, the French guidelines for preventing cross-transmission of multiresistant bacteria were applied. Because the number of VRE cases continued to increase, an institutional control programme was implemented from January 2006 onwards: It foresees stopping transfer of VRE and contact patients, separating VRE and contact patients in distinct cohorts, intervention of a central infection control team to support local teams, and quick application of measures as soon as first VRE cases are identified. Between August 2004 and December 2010, 45 VRE outbreaks occurred in 21 of the 38 AP-HP hospitals, comprising 533 cases. Time series analysis showed that the mean number of cases increased by 0.8 cases per month (95% confidence interval (CI): 0.3 to 1.3, p=0.001) before, and decreased by 0.7 cases per month after implementation of the programme (95% CI: -0.9 to -0.5, p<0.001), resulting in a significant trend change of -1.5 cases per month (95% CI: -2.1 to -0.9, p<0.001). The number of cases per outbreak was significantly lower after implementation of the programme. A sustained and coordinated strategy can control emerging bacteria at the level of a large regional multihospital institution.
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Eurosurveillance, Volume 17, Issue 30, 26 July 2012
Surveillance and outbreak reports
Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a large multihospital institution: a seven-year experience
Surveillance and outbreak reports
Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a large multihospital institution: a seven-year experience
S Fournier (
- Direction de la Politique M?dicale (Directorate of Medical Politics), Assistance Publique-H?pitaux de Paris, Paris, France
- Bacteriology laboratory, Universit? Pierre et Marie CURIE ? Paris 6, H?pital Piti?-Salp?tri?re, Assistance publique ? H?pitaux de Paris, Paris, France
- Bic?tre Hospital, Assistance publique ? H?pitaux de Paris, Kremlin-Bic?tre, France
- Departement of hospital informatics, European hospital Georges Pompidou, Assistance publique ? H?pitaux de Paris, Paris, France
- Emile Roux Hospital, Assistance publique ? H?pitaux de Paris, Limeil-Br?vannes, France
- Charles Foix Hospital, Assistance publique ? H?pitaux de Paris, Ivry-Sur-Seine, France
- Saint Antoine Hospital, Assistance publique ? H?pitaux de Paris, Paris, France
- La Coll?giale Hospital, Assistance publique ? H?pitaux de Paris, Paris, France
- Paul Brousse Hospital, Assistance publique ? H?pitaux de Paris, Villejuif, France
- Bichat-Claude Bernard Hospital, Assistance publique ? H?pitaux de Paris, Paris, France
- Avicenne Hospital, Assistance publique ? H?pitaux de Paris, Bobigny, France
- Sainte P?rine Hospital, Assistance publique ? H?pitaux de Paris, Paris, France
- Beaujon Hospital, Assistance publique ? H?pitaux de Paris, Beaujon, France
- Necker Hospital, Assistance publique ? H?pitaux de Paris, Paris, France
- Henri Mondor Hospital, Assistance publique ? H?pitaux de Paris, Cr?teil, France
Citation style for this article: Fournier S, Brossier F, Fortineau N, Gillaizeau F, Akpabie A, Aubry A, Barbut F, Chedhomme FX, Kassis-Chikhani N, Lucet JC, Robert J, Seytre D, Simon I, Vanjak D, Zahar JR, Brun-Buisson C, Jarlier V. Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a large multihospital institution: a seven-year experience. Euro Surveill. 2012;17(30)
ii=20229. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20229 Date of submission: <HR>Repeated outbreaks of vancomycin-resistant Enterococcus faecium (VRE) occurred between 2004 and 2010 in Assistance Publique ? H?pitaux de Paris (AP-HP), a 23,000-bed multi-hospital institution. From August 2004 to December 2005, the French guidelines for preventing cross-transmission of multiresistant bacteria were applied. Because the number of VRE cases continued to increase, an institutional control programme was implemented from January 2006 onwards: It foresees stopping transfer of VRE and contact patients, separating VRE and contact patients in distinct cohorts, intervention of a central infection control team to support local teams, and quick application of measures as soon as first VRE cases are identified. Between August 2004 and December 2010, 45 VRE outbreaks occurred in 21 of the 38 AP-HP hospitals, comprising 533 cases. Time series analysis showed that the mean number of cases increased by 0.8 cases per month (95% confidence interval (CI): 0.3 to 1.3, p=0.001) before, and decreased by 0.7 cases per month after implementation of the programme (95% CI: -0.9 to -0.5, p<0.001), resulting in a significant trend change of -1.5 cases per month (95% CI: -2.1 to -0.9, p<0.001). The number of cases per outbreak was significantly lower after implementation of the programme. A sustained and coordinated strategy can control emerging bacteria at the level of a large regional multihospital institution.