Epidemiology and control of vancomycin-resistant enterococci in a regional neonatal intensive care unit

Pediatr Infect Dis J. 1999 Apr;18(4):352-6. doi: 10.1097/00006454-199904000-00009.


Background: After the occurrence of two cases of bloodstream infection with vancomycin-resistant enterococci (VRE) in our regional neonatal intensive care unit, we studied the epidemiology of VRE and applied extensive infection control measures to the unit to control VRE transmission.

Methods: Infection control measures applied to the unit included weekly surveillance for VRE colonization; education; cohorting of VRE-positive, VRE-negative and VRE-exposed babies with separate personnel and equipment for each group; use of gowns and gloves on room entry; and hand washing before and after each patient contact. Risk factors for VRE colonization were determined with a stepwise logistic regression model.

Results: Thirty-three (40.2%) babies became colonized with VRE. The VRE colonization rate was reduced from 67% to 7% after implementation of infection control measures. Prolonged antimicrobial treatment and low birth weight were significantly associated with an increased risk of VRE colonization.

Conclusion: VRE can spread rapidly among newborns in a regional neonatal intensive care unit. Strict infection control measures can reduce the rate of VRE colonization among neonates.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Drug Resistance, Microbial
  • Electrophoresis, Gel, Pulsed-Field
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / prevention & control*
  • Humans
  • Infant, Newborn
  • Infection Control
  • Intensive Care Units, Neonatal
  • Risk Factors
  • Vancomycin / pharmacology*


  • Anti-Bacterial Agents
  • Vancomycin