Hygeia Public Health 2016, 51(2): 134-140pl

Vancomycin-resistant enterococci as etiologic agents in healthcare-associated infections - pathogenicity and control methods

Anna Szczypta ^1/, Katarzyna Talaga ^2/, Małgorzata Bulanda ^2/

1/ Wydział Zdrowia i Nauk Medycznych, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
2/ Katedra Mikrobiologii, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie

Summary
Hospital-acquired infections caused by vancomycin-resistant enterococci develop in at-risk patients. The hospital environment is particularly accountable for the selective pressure and the emergence of multiresistant enterococcal strains, including strains with the HLAR and VRE phenotypes. The presence of VRE strains may be of various character ranging from occasional, through epidemic, to the occurrence of a high endemic level. During an outbreak, environmental pollution can play a major role in the transmission of VRE strains. Enterococci can easily spread from patient to patient, most frequently through contaminated hands of medical staff, but also when patients come in direct contact. Heterogeneous strains and the ones more sensitive to antibiotics are replaced by enterococcal strains belonging to the hyperepidemic multi-drug resistant clonal complexes found in the hospital environment. The purpose of isolation is to prevent the transfer of VRE strains from infected or colonized patients to other people (patients, staff, visitors). Other elements of patient isolation and supervision of an epidemic outbreak are: hand decontamination, personal protective equipment, hospital linen segregation, waste management and maintenance of cleanliness at medical units.

Key words:  vancomycin-resistant enterococci, outbreaks, surveillance, isolation