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Vancomycin-resistant enterococci outbreak, Germany, and calculation of outbreak start.

Sagel U, Schulte B, Heeg P, Borgmann S - Emerging Infect. Dis. (2008)

Bottom Line: On the basis of a large outbreak of vancomycin-resistant Enterococcus faecium in a German university hospital, we estimated costs ( approximately 1 million Euros) that could have been avoided by early detection of the imminent outbreak.For this purpose, we demonstrate an easy-to-use statistical method.

View Article: PubMed Central - PubMed

Affiliation: analyse BioLab GmbH, Linz, Austria.

ABSTRACT
On the basis of a large outbreak of vancomycin-resistant Enterococcus faecium in a German university hospital, we estimated costs ( approximately 1 million Euros) that could have been avoided by early detection of the imminent outbreak. For this purpose, we demonstrate an easy-to-use statistical method.

Show MeSH
Course of vancomycin-resistant enterococci (VRE) outbreak at a German university hospital and time point (arrowhead, 30th calendar week; arrow, 31st calendar week) when outbreak alert could have been given. A) Number of VRE-carrying patients treated in a university hospital in 2004 and 2005. Given is the number of patients who were identified for the first time within a certain month (incident cases). In 2004 the first VRE patient was discovered in April 2005. B) Sum of VRE-exhibiting patients (cumulative number of patients [incident cases]) within distinct calendar weeks in 2004 (black line). Trend line (gray line) indicates exponential increase of numbers of incident cases (y = 0.002, χ2 – 0.3497 × 1.0299 [R2 = 0.9918]).
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Figure 1: Course of vancomycin-resistant enterococci (VRE) outbreak at a German university hospital and time point (arrowhead, 30th calendar week; arrow, 31st calendar week) when outbreak alert could have been given. A) Number of VRE-carrying patients treated in a university hospital in 2004 and 2005. Given is the number of patients who were identified for the first time within a certain month (incident cases). In 2004 the first VRE patient was discovered in April 2005. B) Sum of VRE-exhibiting patients (cumulative number of patients [incident cases]) within distinct calendar weeks in 2004 (black line). Trend line (gray line) indicates exponential increase of numbers of incident cases (y = 0.002, χ2 – 0.3497 × 1.0299 [R2 = 0.9918]).

Mentions: At this hospital ≈68,000 inpatients and 220,000 outpatients are treated each year. In 2003, 5 VRE-colonized patients were identified. In 2004, VRE were first detected in April. While at most 3 cases per month were observed through July, 8 colonized patients were found in August (Figure 1, panel A). The number of colonized patients remained relatively high in the following months. By the end of December, the cumulative number of patients with VRE was 48 (Figure 1, panel B). Although medical microbiologists were concerned about a possible outbreak as early as August, decision makers were reluctant to acknowledge a situation that needed action to be taken until January 2005. At that time, an infection control program was implemented. It included VRE screening in stool and anal/rectal swab samples from patients exhibiting an increased risk for VRE carriage (2). This program resulted in a sharp increase of detected cases to a total of 105 patients for February and March 2005 (Figure 1, panel A).


Vancomycin-resistant enterococci outbreak, Germany, and calculation of outbreak start.

Sagel U, Schulte B, Heeg P, Borgmann S - Emerging Infect. Dis. (2008)

Course of vancomycin-resistant enterococci (VRE) outbreak at a German university hospital and time point (arrowhead, 30th calendar week; arrow, 31st calendar week) when outbreak alert could have been given. A) Number of VRE-carrying patients treated in a university hospital in 2004 and 2005. Given is the number of patients who were identified for the first time within a certain month (incident cases). In 2004 the first VRE patient was discovered in April 2005. B) Sum of VRE-exhibiting patients (cumulative number of patients [incident cases]) within distinct calendar weeks in 2004 (black line). Trend line (gray line) indicates exponential increase of numbers of incident cases (y = 0.002, χ2 – 0.3497 × 1.0299 [R2 = 0.9918]).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2600185&req=5

Figure 1: Course of vancomycin-resistant enterococci (VRE) outbreak at a German university hospital and time point (arrowhead, 30th calendar week; arrow, 31st calendar week) when outbreak alert could have been given. A) Number of VRE-carrying patients treated in a university hospital in 2004 and 2005. Given is the number of patients who were identified for the first time within a certain month (incident cases). In 2004 the first VRE patient was discovered in April 2005. B) Sum of VRE-exhibiting patients (cumulative number of patients [incident cases]) within distinct calendar weeks in 2004 (black line). Trend line (gray line) indicates exponential increase of numbers of incident cases (y = 0.002, χ2 – 0.3497 × 1.0299 [R2 = 0.9918]).
Mentions: At this hospital ≈68,000 inpatients and 220,000 outpatients are treated each year. In 2003, 5 VRE-colonized patients were identified. In 2004, VRE were first detected in April. While at most 3 cases per month were observed through July, 8 colonized patients were found in August (Figure 1, panel A). The number of colonized patients remained relatively high in the following months. By the end of December, the cumulative number of patients with VRE was 48 (Figure 1, panel B). Although medical microbiologists were concerned about a possible outbreak as early as August, decision makers were reluctant to acknowledge a situation that needed action to be taken until January 2005. At that time, an infection control program was implemented. It included VRE screening in stool and anal/rectal swab samples from patients exhibiting an increased risk for VRE carriage (2). This program resulted in a sharp increase of detected cases to a total of 105 patients for February and March 2005 (Figure 1, panel A).

Bottom Line: On the basis of a large outbreak of vancomycin-resistant Enterococcus faecium in a German university hospital, we estimated costs ( approximately 1 million Euros) that could have been avoided by early detection of the imminent outbreak.For this purpose, we demonstrate an easy-to-use statistical method.

View Article: PubMed Central - PubMed

Affiliation: analyse BioLab GmbH, Linz, Austria.

ABSTRACT
On the basis of a large outbreak of vancomycin-resistant Enterococcus faecium in a German university hospital, we estimated costs ( approximately 1 million Euros) that could have been avoided by early detection of the imminent outbreak. For this purpose, we demonstrate an easy-to-use statistical method.

Show MeSH