A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit
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(2020) 9:154
RESEARCH
Open Access
A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit Stefanie Kampmeier* , Hauke Tönnies, Carlos L. Correa-Martinez, Alexander Mellmann and Vera Schwierzeck
Abstract Background: Currently, hospitals have been forced to divert substantial resources to cope with the ongoing coronavirus disease 2019 (COVID-19) pandemic. It is unclear if this situation will affect long-standing infection prevention practices and impact on healthcare associated infections. Here, we report a nosocomial cluster of vancomycin-resistant enterococci (VRE) that occurred on a COVID-19 dedicated intensive care unit (ICU) despite intensified contact precautions during the current pandemic. Whole genome sequence-based typing (WGS) was used to investigate genetic relatedness of VRE isolates collected from COVID-19 and non-COVID-19 patients during the outbreak and to compare them to environmental VRE samples. Methods: Five VRE isolated from patients (three clinical and two screening samples) as well as 11 VRE and six vancomycin susceptible Enterococcus faecium (E. faecium) samples from environmental sites underwent WGS during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). Results: WGS revealed two genotypic distinct VRE clusters with genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control bundle strategies. Conclusions: Our results illustrate the importance of continued adherence to infection prevention and control measures during the COVID-19 pandemic to prevent VRE transmission and healthcare associated infections. Keywords: vanB, Nosocomial VRE cluster, Healthcare-associated infection, Surface contamination, Intensive care unit, COVID-19
Introduction In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was discovered in Wuhan City, China and rapidly developed into a pandemic that poses a serious threat to health care systems worldwide [1–3]. It soon became apparent that even in developed countries COVID-19 will set an unprecedented challenge to hospitals due to a high influx of critically ill patients, demand for mechanical ventilation beds and * Correspondence: [email protected] Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany
shortage of personal protective equipment (PPE) [4–6]. Understandably, major staff and financial resources have been diverted to COVID-19 outbreak management in hospitals, especially in regions with high case numbers [7]. One concern among the infection prevention community is that the COVID-19 pandemic will cause “collateral damage” to long-established infection control measures including the prevention of healthcareassociated infections [8]. So far, it remains unknown if the present diversion of hospital resources and changes in infection control practices will translate into an increase of nosocomial trans
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