北部某醫學中心內科加護病房萬古黴素抗藥性腸球菌群突發調查報告

Vancomycin-resistant enterococci (VRE) had been reported sincel988 and became an important clinical issue. However, it was not found in the medical intensive care unit (MICU) of our hospital before 2007. In September 2007, health care-associated infection due to vancomycin-resistant Enterococcus faecium were found in 4 cases in the MICU and an outbreak of VRE was suspected. Retrospective review found 8 clinical isolates each in 8 patients from July through September 2007. Relevant survey revealed that 5 of 8 patients and 2 of their 10 roommates were found with bowel carriage of VRE. However, none of the 81 specimens collected from patient-related surroundings yielded VRE. The 15 isolates were classified into three patterns of phenotypes by Pulsed-field gel electrophoresis (PFGE). Thirteen of the 15 isolates were in the same phenotype. Seven patients and I roommate were found in this group and an outbreak was confirmed. The outbreak was resolved by strict performance of contact isolations and bowel precautions according to in-time microbiological information. The authors emphasized that strict performance of environmental cleaning at ward and contact precaution were mandatory for controlling VRE outbreak.