Control of Transmission of Vancomycin-Resistant Enterococcus faecium in a Long-Term–Care Facility

1999 ◽  
Vol 20 (05) ◽  
pp. 312-317 ◽  
Author(s):  
Maxine Armstrong-Evans ◽  
Margaret Litt ◽  
Margaret A. McArthur ◽  
Barbara Willey ◽  
Darlene Cann ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Long Term Care Facility ◽  
Rectal Swabs ◽  
Vancomycin Resistant ◽  
And Control

AbstractObjectives:To describe the investigation and control of transmission of vancomycin-resistant enterococci (VRE) in a residential long-term-care (LTC) setting.Outbreak Investigation:A strain of vancomycin-resistantEnterococcus faeciumnot previously isolated in Ontario colonized five residents of a 254-bed LTC facility in Toronto. The index case was identified when VRE was isolated from a urine culture taken after admission to a local hospital. Screening of rectal swabs from all 235 residents identified four others who were colonized with the same strain ofE faecium.Control Measures:Colonized residents were cohorted. VRE precautions were established as follows: gown and gloves for resident contact, restriction of contact between colonized and noncolonized residents, no sharing of personal equipment, and daily double-cleaning of residents' rooms and wheelchairs.Outcome:Two colonized residents died of causes unrelated to VRE. Although bacitracin therapy (75,000 units four times a day X 14 days) failed to eradicate carriage in two of three surviving residents, both cleared their carriage within 7 weeks. Repeat rectal swabs from 224 residents (91%) 2 months after isolation precautions were discontinued and from 125 residents (51%) 9 months later identified no new cases. Total cost of investigation and control was $12,061 (Canadian).Conclusion:VRE may be transmitted in LTC facilities, and colonized LTC residents could become important VRE reservoirs. Control of VRE transmission in LTC facilities can be achieved even with limited resources.

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

Preventing the Spread of Vancomycin-Resistant Enterococci in a Long-Term Care Facility

2000 ◽  
Vol 48 (10) ◽  
pp. 1211-1215 ◽  
Author(s):  
Fredric J. Silverblatt ◽  
Cynthia Tibert ◽  
Dennis Mikolich ◽  
Julia Blazek-D'Arezzo ◽  
Josephine Alves ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Failure to Control an Outbreak of Multidrug-ResistantStreptococcus pneumoniaein a Long-Term–Care Facility Emergence and Ongoing Transmission of a Fluoroquinolone-Resistant Strain

2005 ◽  
Vol 26 (3) ◽  
pp. 248-255 ◽  
Author(s):  
Rosalind J. Carter ◽  
Genevieve Sorenson ◽  
Richard Heffernan ◽  
Julia A. Kiehlbauch ◽  
John S. Kornblum ◽  
...  
Keyword(s):  
Long Term Care ◽  
Antimicrobial Prophylaxis ◽  
Care Facility ◽  
Control Measures ◽  
Fluoroquinolone Resistance ◽  
Outbreak Strain ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

AbstractObjectives:To characterize risk factors associated with pneumococcal disease and asymptomatic colonization during an outbreak of multidrug-resistantStreptococcus pneumoniae(MDRSP) among AIDS patients in a long-term–care facility (LTCF), evaluate the efficacy of antimicrobial prophylaxis in eliminating MDRSP colonization, and describe the emergence of fluoroquinolone resistance in the MDRSP outbreak strain.Design:Epidemiologic investigation based on chart review and characterization of SP strains by antimicrobial susceptibility testing and PFGE and prospective MDRSP surveillance.Setting:An 80-bed AIDS-care unit in an LTCF.Participants:Staff and residents on the unit.Results:From April 1995 through January 1996, 7 cases of MDRSP occurred. A nasopharyngeal (NP) swab survey of all residents (n = 65) and staff (n = 70) detected asymptomatic colonization among 6 residents (9%), but no staff. Isolates were sensitive only to rifampin, ofloxacin, and vancomycin. A 7-day course of rifampin and ofloxacin was given to eliminate colonization among residents: NP swab surveys at 1, 4, and 10 weeks after prophylaxis identified 1 or more colonized residents at each follow-up with isolates showing resistance to one or both treatment drugs. Between 1996 and 1999, an additional 6 patients were diagnosed with fluoroquinolone-resistant (FQ-R) MDRSP infection, with PFGE results demonstrating that the outbreak strain had persisted 3 years after the initial outbreak was recognized.Conclusions:Chemoprophylaxis likely contributed to the development of a FQ-R outbreak strain that continued to be transmitted in the facility through 1999. Long-term control of future MDRSP outbreaks should rely primarily on vaccination and strict infection control measures.

scholarly journals An outbreak of norovirus infection in a long-term care facility in Brazil

2010 ◽  
Vol 8 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Fernando Gatti de Menezes ◽  
Vanessa Maria da Silva de Poli Correa ◽  
Fábio Gazelato de Mello Franco ◽  
Miriam Ikeda Ribeiro ◽  
Maria Fátima dos Santos Cardoso ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Control Strategies ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures

ABSTRACT Objective: To describe a norovirus outbreak in a Brazilian long-term care facility from July 8 to 29, 2005. Methods: In the first 48 to 72 hours after onset of symptoms in inpatients and employees, the main infection control strategies were staff education, emphasis on hand washing, implementing contact precautions up to 48-72 hours after resolution of symptoms, complete cleaning of the rooms and exclusion of symptomatic employees from work until 48-72 hours after resolution of their symptoms. Epidemiological and clinical characteristics of the norovirus infections were described based on chart review. Results: The incidence among inpatients and employees was 41.3% and 16.25%, respectively. The main symptom was diarrhea, affecting 100% of inpatients and employees. Forty-four percent of specimens were positive by RIDASCREEN® Norovirus analyses, and identified as norovirus genogroup GII. Seventy percent of inpatients were women and their age range was 51-98 years. Inpatients had in average two comorbid conditions – 87.3% with cardiovascular or chronic pulmonary condition and 47.6% with dementia. There was not relapse or death. Conclusions: The early infection-control measures associated to surveillance are required to keep long-term care facilities free of noroviruses and to protect those who are most vulnerable.

scholarly journals Knowledge, Attitudes, and Practices of Pediatric Long-term Care Facility Staff Regarding Infection Control for Acute Respiratory Infections and Influenza Vaccination

2019 ◽  
Author(s):  
Lisa Saiman ◽  
Sibyl Wilmont ◽  
Alexandra Hill-Ricciuti ◽  
Meaghan Jain ◽  
Emily Collins ◽  
...  
Keyword(s):  
Long Term Care ◽  
Respiratory Infections ◽  
Care Facility ◽  
Clinical Staff ◽  
Acute Respiratory Infections ◽  
Term Care ◽  
Long Term Care Facility ◽  
Attitudes And Practices ◽  
And Control

Abstract We surveyed clinical staff and on-site teachers working at pediatric long-term care facilities regarding prevention and control of acute respiratory infections and influenza in staff and residents. We uncovered knowledge gaps, particularly among teachers and clinical staff working <5 years at sites, thereby elucidating areas for targeted staff education.

Natural History of Colonization With Vancomycin-Resistant Enterococci, Methicillin-Resistant Staphylococcus Aureus, And Resistant Gram-Negative Bacilli Among Long-Term–Care Facility Residents

2003 ◽  
Vol 24 (4) ◽  
pp. 246-250 ◽  
Author(s):  
Glenn A. Pacio ◽  
Paul Visintainer ◽  
George Maguire ◽  
Gary P. Wormser ◽  
John Raffalli ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Gram Negative ◽  
Long Term Care Facility ◽  
Vancomycin Resistant Enterococci ◽  
History Of ◽  
Vancomycin Resistant

AbstractObjective:To determine the natural history of colonization with vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and resistant gram-negative bacilli among long-term–care facility (LTCF) residents.Design:Observational cohort study.Setting:A 355-bed LTCF with a ventilator unit and a subacute unit.Participants:Residents with colonization or infection with VRE, MRSA or resistant gram-negative bacilli housed at the LTCF between December 1,1999, and February 29, 2000.Methods:Cultures of clinical and surveillance sites were performed at regular intervals. Charts were reviewed for clinical characteristics associated with clearance of colonization. Kaplan–Meier curves were constructed to analyze the number of days to clearance of colonization.Results:Forty-nine residents had 65 episodes of colonization (27 VRE, 30 MRSA and 8 resistant gram-negative bacilli). Eighteen (28%) of the episodes cleared. The clearance rate was 2.7 episodes per 1,000 person-days. Clearance occurred significantly more often with resistant gram-negative bacilli colonization compared with VRE or MRSA colonization (6 [75%] vs 12 [21%]; P = .007; relative risk, 4.17; 95% confidence interval, 1.26 to 11.8). There was a trend toward longer use of antimicrobial agents among residents with persistent colonization. Infections occurred most frequently with MRSA The urinary tract was the most common site of infection.Conclusion:Among LTCF residents, colonization with resistant gram-negative bacilli is four times more likely to clear than colonization with VRE or MRSA. Performance of surveillance cultures at regular intervals may reduce the need for contact precautions for LTCF residents with resistant gram-negative bacilli colonization.

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