Saito N, Kitazawa J, Horiuchi H, Yamamoto T, Kimura M, Inoue F, Matsui M, Minakawa S, Itoga M, Tsuchiya J, Suzuki S, Hisatsune J, Gu Y, Sugai M, Kayaba H. Interhospital transmission of vancomycin-resistant Enterococcus faecium in Aomori, Japan.
Antimicrob Resist Infect Control 2022;
11:99. [PMID:
35871001 PMCID:
PMC9308179 DOI:
10.1186/s13756-022-01136-5]
[Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background
Spread of vancomycin-resistant Enterococcus (VRE) is a global concern as a significant cause of healthcare-associated infections. A series of VRE faecium (VREf) outbreaks caused by clonal propagation due to interhospital transmission occurred in six general hospitals in Aomori prefecture, Japan.
Methods
The number of patients with VREf was obtained from thirty seven hospitals participating in the local network of Aomori prefecture. Thirteen hospitals performed active screening tests for VRE. Whole genome sequencing analysis was performed.
Results
The total number of cases with VREf amounted to 500 in fourteen hospitals in Aomori from Jan 2018 to April 2021. It took more than three years for the frequency of detection of VRE to return to pre-outbreak levels. The duration and size of outbreaks differed between hospitals according to the countermeasures available at each hospital. Whole genome sequencing analysis indicated vanA-type VREf ST1421 for most samples from six hospitals.
Conclusions
This was the first multi-jurisdictional outbreak of VREf sequence type 1421 in Japan. In addition to strict infection control measures, continuous monitoring of VRE detection in local medical regions and smooth and immediate communication among hospitals are required to prevent VREf outbreaks.
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