Acute vancomycin-resistant enterococcal bacteraemia outbreak analysis in haematology patients: a case-control study

Gassiep, Ian, Armstrong, Mark, Van Havre, Zoe, Schlebusch, Sanmarie, McCormack, Joseph and Griffin, Paul (2015) Acute vancomycin-resistant enterococcal bacteraemia outbreak analysis in haematology patients: a case-control study. Healthcare Infection, 20 4: 115-123. doi:10.1071/HI15013


Author Gassiep, Ian
Armstrong, Mark
Van Havre, Zoe
Schlebusch, Sanmarie
McCormack, Joseph
Griffin, Paul
Title Acute vancomycin-resistant enterococcal bacteraemia outbreak analysis in haematology patients: a case-control study
Journal name Healthcare Infection   Check publisher's open access policy
ISSN 1835-5617
1835-5625
Publication date 2015-08-17
Sub-type Article (original research)
DOI 10.1071/HI15013
Open Access Status Not Open Access
Volume 20
Issue 4
Start page 115
End page 123
Total pages 9
Place of publication Clayton, VIC, Australia
Publisher C S I R O Publishing
Collection year 2016
Language eng
Formatted abstract
Introduction: We report a retrospective case-control series of a vancomycin-resistant Enterococcus faecium (VRE) bacteraemia outbreak at a tertiary metropolitan hospital in Queensland, Australia. The outbreak occurred on a haematology ward between 8 and 14 February 2014, 6 weeks after a ward relocation. The aim was to determine risk factors related to progression from colonisation with VRE to bacteraemia.

Methods: The cases were patients with haematological malignancy and proven catheter-related VRE bacteraemia. Matched controls were selected from the same ward with similar underlying haematological diagnoses and proven gastrointestinal VRE colonisation without invasive infection.

Results: This study suggests that female sex, recent administration of total parenteral nutrition, right-sided catheter placement with odds ratios (OR) 1.99, gastrointestinal disruption (OR: 1.91), and dexamethasone administration (OR: 2.37) are potential risk factors for progression from colonisation to infection. Notably, given the small sample size, the 95% confidence intervals are wide ranging from 0.02 to 222.

Conclusion: While progression from colonisation with VRE to invasive disease is likely to be a complex multifactorial process, the results of this study suggest certain clinical variables that warrant enhanced vigilance to reduce this occurrence. Interestingly, recent relocation of the haematology ward may play a significant role in this outbreak. This study highlights the importance of good infection control practice and the need for additional studies to further delineate risk factors for invasive VRE infection.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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Created: Wed, 04 Nov 2015, 08:45:06 EST by Paul Griffin on behalf of Medicine - Mater Hospital