Outbreak Of Vancomycin-Resistant Enterococci In A Surgical Intensive Care Unit

Introduction: Enterococci have increasing importance in intensive care units, and vancomycin-resistant strains express a new challenge. Aim: The aim of the authors was to present their findings obtained from the first vancomycin-resistant enterococci outbreak occurred in 2013 at the Intensive Care Unit of the 1st Department of Surgery, Semmelweis University. Method: This was a case-control study of patients who had Enterococci species isolated from their microbiological samples between January 1 and June 30, 2013. Changes of Enterococcal incidence and consequences of vancomycin-resistance in patient outcome were analyzed. Demographic data, hospital length of stay and mortality data were also collected. Results: Enterococci were isolated from 114 patients and 14 of them had vancomycinresistant strains. The incidence of Enterococcal strains was not different in the periods before and after the outbreak of the first vancomycin-resistant Enterococci. Patients with vancomycin-resistant Enterococci had significantly higher mortality rate than those with vancomycin-sensitive Enterococcus (42.9% vs 30.0%, p = 0.005); however, length of stay was not significantly different. Co-morbidities and emergency surgery were significantly higher in patients who had vancomycin-resistant Enterococci. Conclusions: The higher mortality observed in patients with vancomycinresistant Enterococcus infections highlights the importance of prevention and appropriate infection control, however, the direct relationship of vancomycin-resistance and increased mortality is questionable.