[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 vancomycin-resistant 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 vancomycin-resistant Enterococcus infections highlights the importance of prevention and appropriate infection control, however, the direct relationship of vancomycin-resistance and increased mortality is questionable.