Vancomycin-resistant Enterococcus infections in a hospital in Salvador, Bahia: a descriptive study, 2021-2023

Abstract

Objective: To address the occurrence of an outbreak of vancomycin-resistant Enterococcus in inpatient units intended for COVID-19 patients in a hospital in Salvador, Brazil, specialized in infectious diseases, which underwent several adaptations with effect from March 2020. Methods: This is a descriptive study of patients with positive culture results for vancomycin-resistant Enterococcus between January 2021 and December 2023. The vanA/vanB genotype was defined by real-time polymerase chain reaction, and the clonal profile, by pulsed-field gel electrophoresis. Descriptive analyses were performed and presented as proportions. Results: Fifteen Enterococcus spp. infected/colonized patients were identified, of which 7 were E. faecalis, 7 were E. faecium and 1 was E. gallinarum. Two clonal profiles were identified: E. faecalis profile A and E. faecium profile C. The vanA genotype was predominant. Possible cross-contamination of disinfected materials and other dirty materials used for bathing and waste disposal was detected in utility/sluice room sinks. Conclusion: The vancomycin-resistant Enterococcus outbreak in the inpatient units was controlled after implementing a unidirectional flow of disinfection of materials in utility/sluice rooms.