Epidemiology and control of vancomycin-resistant enterococci in a regionalneonatal intensive care unit

Background. After the occurrence of two cases of bloodstream infection with vancomycin-resistant enterococci (VRE) in our regional neonatal intensive care unit, we studied the epidemiology of VRE and applied extensive infecti on control measures to the unit to control VRE transmission. Methods. Infection control measures applied to the unit included weekly sur veillance for VRE colonization; education; cohorting of VRE-positive, VRE-n egative and VRE-exposed babies with separate personnel and equipment for ea ch group; use of gowns and gloves on room entry; and hand washing before an d after each patient contact. Risk factors for VRE colonization were determ ined with a stepwise logistic regression model. Results. Thirty-three (40.2%) babies became colonized with VRE. The VRE col onization rate was reduced from 67% to 7% after implementation of infection control measures. Prolonged antimicrobial treatment and low birth weight w ere significantly associated with an increased risk of VRE colonization. Conclusion. VRE can spread rapidly among newborns in a regional neonatal in tensive care unit. Strict infection control measures can reduce the rate of VRE colonization among neonates.