Clinical and molecular biological analysis of a nosocomial outbreak of vancomycin-resistant enterococci in a neonatal intensive care unit

Vancomycin-resistant enterococci (VRE) have emerged as important nosocomial pathogens since 1988. We report here an outbreak of VRE between April 1997 and May 1997 in our neonatal intensive care unit (NICU). All isolates from four patients were identified as Enterococcus faecium positive and were re sistant to vancomycin and teicoplanin. All of the patients with VRE were is olated for at least 5 d after admission to the unit and the positive cultur es lasted between 13 and 31 d. There were no cases of sepsis or mortality i n the patients with VRE. Two cases had previously received vancomycin thera py. All isolates were shown to have the vanA gene and had the same band pat tern on repetitive PCR. After the four episodes, all equipment used to care for the patients were decontaminated and the staff engaged in therapy used disposable gloves and gowns. There were no more episodes. However, the NIC U is no longer a safety area with regards to vancomycin-resistant enterococ cal infection.