[Outbreak of vancomycin-resistant Enterococcus faecium (Van B) at the Bethune Hospital (France). Two point-prevalence surveys: May 2008 and January 2009].

OBJECTIVE

An outbreak of vancomycin-resistant Enterococcus faecium (E. faecium) occurred in the Bethune Hospital since March 2008 (two consecutive waves). To control this outbreak, two-point prevalence surveys were conducted in May 2008 and January 2009 in inpatients hospitalised more than 24 hours on previously non-affected wards.

METHODS

In each ward, information was given to inpatients, administrative and medical data were collected, rectal swabs or stool samples were performed and cultured on chromogenic media. Data were anonymised, and Epidata software was used for the analysis.

RESULTS

In May 2008, nine patients were found to be colonized with vancomycin-resistant E. faecium among the 239 patients evaluated (prevalence : 3.76%), and three new wards were affected: neurology ward, general surgical ward, and emergency department observation unit. In January 2009, only one patient, hospitalised in cardiac intensive care unit, was colonised among the 157 patients evaluated (prevalence 0.63%).

CONCLUSIONS

These two-point prevalence surveys identified the reservoir of vancomycin-resistant E. faecium carriage, and were thus helpful to contain the two epidemic waves at the Bethune Hospital. A cohorting of the colonised inpatients was performed. Five secondary colonisation cases were detected among the 181 contact patients in May 2008, and no secondary case among 32 contact patients in January 2009.