Eradication of an outbreak of vancomycin-resistant Enterococcus (VRE): the cost of a failure in the systematic screening

Antimicrobial Resistance and Infection Control

Daniel Vittecoq³  Paul Presiozi⁵  Najiby Kassis¹  Faouzi Saliba⁶  Eric Rudant⁷  Marie Frank-Soltysiak²  Samir Bouam⁴  Lélia Escaut³ 

[1]Laboratory of microbiology, Paul Brousse Hospital, Villejuif, France

[2]Department of public health, Bicêtre Hospital, Le Kremlin-Bicêtre, France

[3]Department of infectious and tropical diseases, Bicêtre Hospital, Unité de Maladies Infectieuses et Tropicales, Hôpital Paul Brousse, 78, rue du Général Leclerc, Le Kremlin-Bicêtre 94270, France

[4]Department of hospital information, Paul Brousse Hospital, Villejuif, France

[5]ClinSearch, Bagneux, France

[6]Hepatobiliary centre, Paul Brousse Hospital, Villejuif, France

[7]Laboratory of pharmacy, Paul Brousse Hospital, Villejuif, France

关键词: Vancomycin-resistant Enterococcus;    Cost;    Outbreak;    Active surveillance;   

Others  :  790828
DOI  :  10.1186/2047-2994-2-18

 received in 2012-12-04, accepted in 2013-03-29,  发布年份 2013

【 摘 要 】

Background

Vancomycin-resistant enterococci (VRE) are still a concern in hospital units tending to seriously ill patients. However, the cost-effectiveness of active surveillance program to identify asymptomatically VRE colonized patient remains debatable. This work aims at evaluating the cost of a failure in the active surveillance of VRE that had resulted in an outbreak in a French University Hospital.

Findings

A VRE outbreak was triggered by a failure in the systematic VRE screening in a medico-surgical ward specialised in liver transplantation as a patient was not tested for VRE. This failure was likely caused by the reduction of healthcare resource. The outbreak involved 13 patients. Colonized patients were grouped in a dedicated part of the infectious diseases unit and tended by a dedicated staff. Transmission was halted within two months after discovery of the index case.

The direct cost of the outbreak was assessed as the cost of staffing, disposable materials, hygiene procedures, and surveillance cultures.

The loss of income from spare isolation beds was computed by difference with the same period in the preceding year. Payments were drawn from the hospital database. The direct cost of the outbreak (2008 Euros) was €60 524 and the loss of income reached €110 915.

Conclusions

Despite this failure, the rapid eradication of the VRE outbreak was a consequence of the rapid isolation of colonized patient. Yet, eradicating even a limited outbreak requires substantial efforts and resources. This underlines that special attention has to be paid to strictly adhere to active surveillance program.

【 授权许可】

   
2013 Escaut et al.; licensee BioMed Central Ltd.

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