Chlebicki Maciej Piotr, Kurup Asok
Department of Internal Medicine, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2008 Oct;37(10):861-9.
Vancomycin-resistant enterococcus (VRE) can cause serious infections in vulnerable, immunocompromised patients.
In this article, we summarise current data on epidemiology, detection, treatment and prevention of VRE.
VRE was first isolated in Singapore in 1994 and until 2004 was only sporadically encountered in our public hospitals. After 2 outbreaks in 2004 and in 2005, VRE has become established in our healthcare institutions. Multiple studies have shown that VRE spreads mainly via contaminated hands, cloths and portable equipment carried by healthcare workers.
Only a comprehensive programme (consisting of active surveillance, isolation of colonised/infected patients, strict adherence to proper infection control practices and anti-microbial stewardship) can limit the spread of these organisms. In addition to monitoring the compliance with traditional infection control measures, new strategies that merit consideration include pre-emptive isolation of patients in high-risk units and molecular techniques for the detection of VRE.
耐万古霉素肠球菌（VRE）可在脆弱的免疫功能低下患者中引起严重感染。
在本文中，我们总结了关于VRE的流行病学、检测、治疗和预防的当前数据。
VRE于1994年在新加坡首次分离出来，直到2004年在我们的公立医院中仅偶尔遇到。在2004年和2005年发生两次疫情后，VRE在我们的医疗机构中已站稳脚跟。多项研究表明，VRE主要通过医护人员携带的受污染的手、衣物和便携式设备传播。
只有一个综合方案（包括主动监测、对定植/感染患者进行隔离、严格遵守适当的感染控制措施和抗菌药物管理）才能限制这些微生物的传播。除了监测对传统感染控制措施的遵守情况外，值得考虑的新策略包括对高危病房的患者进行预防性隔离以及用于检测VRE的分子技术。
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