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Prävention und Kontrolle der Ausbreitung von Vancomycin-resistenten Enterokokken

Ergebnisse eines Workshops der Deutschen Gesellschaft für Hygiene und Mikrobiologie

Prevention and control of the spread of vancomycin-resistant enterococci

Results of a workshop held by the German Society for Hygiene and Microbiology

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Zusammenfassung

Die Inzidenz von Erkrankungen durch Vancomycin-resistente Enterokokken (VRE), insbesondere E. faecium, steigt in verschiedenen deutschen Krankenhäusern, und eine Reihe von Ausbrüchen ist dokumentiert. Auch auf den Intensivstationen des Krankenhaus-Infektions-Surveillance-Systems (KISS) wurden in den Jahren von 2003–2005 ein erheblicher Anstieg der VRE-Inzidenz von 0,5 auf 11,0/10.000 Patienten und ein Anstieg der VRE-assoziierten Letalität beobachtet. Die Gründe für diese Entwicklung sind nicht abschließend geklärt. Da VRE aber schwere Infektionen verursachen können, muss ihre Übertragung durch geeignete Maßnahmen verhindert werden. Der vorliegende Beitrag fasst die in einem Workshop erarbeiteten Empfehlungen der Deutschen Gesellschaft für Hygiene und Mikrobiologie zur Prävention von VRE-Transmissionen bei endemischem und epidemischem Auftreten zusammen. Diskutiert werden die Indikationen zum VRE-Screening, mikrobiologische Diagnostik und allgemeine (Isolierung und Schutzkleidung) sowie zusätzliche Hygienemaßnahmen während nosokomialer Ausbrüche durch VRE.

Abstract

The incidence of vancomycin-resistant enterococci (VRE), especially E. faecium, is increasing in several German hospitals and some facilities have experienced VRE outbreaks. The German National Nosocomial Infection Surveillance System has also noticed a sharp increase in the incidence of nosocomial VRE infections per 10,000 patients from 0.5 in 2003 to 11.0 in 2005 accompanied by a rise in VRE-associated mortality. However, the reasons of this increase remain unknown. As VRE may cause severe nosocomial infections, transmission must be restricted. This article provides the guidelines as defined by the workshop of the German Society for Hygiene and Microbiology for the prevention of VRE transmission in both, endemic and epidemic, settings. The following topics are discussed: indication for VRE screening, microbiological diagnostics, general infection control measures (isolation precautions and use of protective clothing) and additional hygiene measures in the nosocomial VRE outbreak setting.

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Authors and Affiliations

  1. Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    R.-P. Vonberg, I.F. Chaberny, A. Kola, F. Mattner & P. Gastmeier

  2. Institut für Mikrobiologie und Hygiene, Universität, Tübingen, Deutschland

    S. Borgmann

  3. Institut für Umweltmedizin und Krankenhaushygiene, Universitätsklinikum, Freiburg, Deutschland

    M. Dettenkofer & D. Jonas

  4. Labor Limbach, Heidelberg, Deutschland

    A.-M. Fahr

  5. Robert-Koch-Institut, Bereich Wernigerode, Deutschland

    I. Klare & G. Werner

  6. Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Campus Benjamin Franklin, Berlin, Deutschland

    K. Weist

  7. Hygiene-Institut, Universität, Heidelberg, Deutschland

    C. Wendt

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  1. R.-P. Vonberg
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  3. A. Kola
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Correspondence to R.-P. Vonberg.

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Vonberg, RP., Chaberny, I., Kola, A. et al. Prävention und Kontrolle der Ausbreitung von Vancomycin-resistenten Enterokokken. Anaesthesist 56, 151–157 (2007). https://doi.org/10.1007/s00101-006-1123-3

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