Christchurch Hospital in New Zealand has recently been dealing with two simultaneous outbreaks of vancomycin resistant enterococci (VRE) on a single ward, a situation confirmed by Health New Zealand. Dr. Sarah Berger, Health NZ Nursing Director for Infection Prevention and Control in Canterbury and the West Coast, outlines that these separate outbreaks involve two distinct strains of VRE, identified as of November 14.
VRE, sometimes deemed a ‘superbug’, poses a significant threat since it displays resistance to the antibiotic vancomycin, making treatment more challenging. The growth of antimicrobial resistance, as stated by Dr. Berger, is an emerging global concern now witnessed in New Zealand as well.
Contrary to the potential alarm, the majority of patients affected in Christchurch Hospital, a number less than 10, act as carriers of VRE without presenting symptoms of an active infection. Yet, as the VRE presence escalates within the community, the management of VRE has become an integral part of routine health practice. A rigorous protocol involving deep ward cleaning and the use of personal protective equipment forms part of the infection prevention strategy. In an effort to ensure these preventive measures are fully understood and adhered to, infection prevention control specialists are ensuring close collaboration with clinical teams.
Furthering patient awareness, these specialists are also conducting comprehensive discussions with patients and their families, supplying information sheets and actively addressing any questions in regard to VRE.
VRE transmission is preventable within healthcare settings. It spreads via contaminated surfaces, patient equipment, and unsanitized hands. Hence, regular hand hygiene is a crucial role that patients, staff, and visitors must undertake. Concurrently, regular laundering and disinfection of surfaces and equipment are also vital in curbing VRE spread.
Being detected with VRE doesn’t detriment the quality of care patients receive. If present, the patient may be isolated to a single room with personal toilet facilities, or grouped with other VRE carriers. Caregivers will adhere to heightened precautions including wearing protective items such as gloves, aprons or gowns. In-hospital mobility of such patients may be restricted with hand sanitizer use necessitated each time they exit their rooms.
Even after discharge, informing healthcare providers about a past VRE presence will allow appropriate precautions to be followed. For protection at the patient’s home, regular hand hygiene with soap and water, especially after bathroom use or before food preparation, is highly recommended. Regular home cleaning methods suffice with no especial procedure necessary for laundry or dishes. A VRE positive patient may be periodically re-tested if readmitted to the hospital and precautions might continue for several years after a positive result, given the difficulty in certifying VRE clearance.