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Abstract

Background

Vancomycin-resistant enterococci (VRE), mostly , are multidrug-resistant microorganisms that can cause nosocomial infections. VRE has increased throughout many European countries, but data from Switzerland are scarce.

Aim

The aim of this work was to characterise the epidemiology of enterococcal bacteraemias in Switzerland with a focus on VRE.

Methods

In this observational study, we retrospectively investigated bacteraemias from 81 healthcare institutions from January 2013 to December 2018 using data from the Swiss Centre for Antibiotic Resistance. Only the first blood isolate with or from an individual patient was considered. We analysed the annual incidences of enterococcal bacteraemias and determined the proportion of VRE over time. We also assessed epidemiological factors potentially associated with VRE bacteraemia.

Results

We identified 5,369 enterococcal bacteraemias, of which 3,196 (59.5%) were due to and 2,173 (40.5%) to . The incidence of enterococcal bacteraemias increased by 3.2% per year (95% confidential interval (CI): 1.6–4.8%), predominantly due to a substantial increase in bacteraemic episodes. Vancomycin resistance affected 30 (1.4%) and one bacteraemic episodes. Among all bacteraemias, the proportion of vancomycin-resistant isolates increased steadily from 2013 to 2018 (2% per year; 95% CI: 1.5–2.9%). No independent epidemiological factor for higher prevalence of vancomycin-resistant bacteraemias was identified.

Conclusions

Vancomycin-resistant bacteraemias remain infrequent in Switzerland. However, an important increase was observed between 2013 and 2018, highlighting the need for implementing active surveillance and targeted prevention strategies in the country.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
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2020-09-03
2024-12-22
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References

  1. Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. Microbiology (Reading). 2009;155(6):1749-57.  https://doi.org/10.1099/mic.0.026385-0  PMID: 19383684 
  2. de Kraker ME, Jarlier V, Monen JC, Heuer OE, van de Sande N, Grundmann H. The changing epidemiology of bacteraemias in Europe: trends from the European Antimicrobial Resistance Surveillance System. Clin Microbiol Infect. 2013;19(9):860-8.  https://doi.org/10.1111/1469-0691.12028  PMID: 23039210 
  3. Buetti N, Marschall J, Atkinson A, Kronenberg A, Swiss Centre for Antibiotic Resistance (ANRESIS). National Bloodstream Infection Surveillance in Switzerland 2008-2014: Different Patterns and Trends for University and Community Hospitals. Infect Control Hosp Epidemiol. 2016;37(9):1060-7.  https://doi.org/10.1017/ice.2016.137  PMID: 27350313 
  4. Arias CA, Murray BE. The rise of the Enterococcus: beyond vancomycin resistance. Nat Rev Microbiol. 2012;10(4):266-78.  https://doi.org/10.1038/nrmicro2761  PMID: 22421879 
  5. Faron ML, Ledeboer NA, Buchan BW. Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting. J Clin Microbiol. 2016;54(10):2436-47.  https://doi.org/10.1128/JCM.00211-16  PMID: 27147728 
  6. Pfaller MA, Cormican M, Flamm RK, Mendes RE, Jones RN. Temporal and Geographic Variation in Antimicrobial Susceptibility and Resistance Patterns of Enterococci: Results From the SENTRY Antimicrobial Surveillance Program, 1997-2016. Open Forum Infect Dis. 2019;6(Suppl 1):S54-62.  https://doi.org/10.1093/ofid/ofy344  PMID: 30895215 
  7. Prematunge C, MacDougall C, Johnstone J, Adomako K, Lam F, Robertson J, et al. VRE and VSE Bacteremia Outcomes in the Era of Effective VRE Therapy: A Systematic Review and Meta-analysis. Infect Control Hosp Epidemiol. 2016;37(1):26-35.  https://doi.org/10.1017/ice.2015.228  PMID: 26434609 
  8. European Centre for Disease Prevention Control (ECDC). Surveillance of antimicrobial resistance in Europe 2018. Stockholm: ECDC; 2019.
  9. Senn L, Petignat C, Chabanel D, Zanetti G. Contrôle d’une épidémie d’entérocoques résistant à la vancomycine dans plusieurs hôpitaux de Suisse romande. [Control of an outbreak of vancomycin-resistant enterococci in several hospitals of western Switzerland]. Rev Med Suisse. 2013;9(383):890-3. PMID: 23697084 
  10. Moulin E, Deggim-Messmer V, Erard V, Christin L, Petignat C, Blanc DS, et al. Entérocoque résistant à la vancomycine (ERV) : une nouvelle réalité dans nos hôpitaux. [Vancomycin-resistant enterocci (VRE): a new reality in our hospitals]. Rev Med Suisse. 2018;14(602):791-4. PMID: 29658219 
  11. Thierfelder C, Keller PM, Kocher C, Gaudenz R, Hombach M, Bloemberg GV, et al. Vancomycin-resistant Enterococcus. Swiss Med Wkly. 2012;142:w13540. PMID: 22618895 
  12. Buetti N, Wassilew N, Rion V, Senn L, Gardiol C, Widmer A, et al. , for Swissnoso. Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey. Antimicrob Resist Infect Control. 2019;8(1):16.  https://doi.org/10.1186/s13756-019-0466-x  PMID: 30675343 
  13. Abdelbary MHH, Senn L, Greub G, Chaillou G, Moulin E, Blanc DS. Whole-genome sequencing revealed independent emergence of vancomycin-resistant Enterococcus faecium causing sequential outbreaks over 3 years in a tertiary care hospital. Eur J Clin Microbiol Infect Dis. 2019;38(6):1163-70.  https://doi.org/10.1007/s10096-019-03524-z  PMID: 30888549 
  14. Wassilew N, Seth-Smith HM, Rolli E, Fietze Y, Casanova C, Führer U, et al. Outbreak of vancomycin-resistant Enterococcus faecium clone ST796, Switzerland, December 2017 to April 2018. Euro Surveill. 2018;23(29):1800351.  https://doi.org/10.2807/1560-7917.ES.2018.23.29.1800351  PMID: 30043725 
  15. Federal Office of Public Health (FOPH). Kennzahlen der Schweizer Spitäler 2017. [Key numbers of Swiss hospitals in 2017]. Liebefeld: FOPH; 2019. German. ISSN 1664-7270.
  16. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495-9.  https://doi.org/10.1016/j.ijsu.2014.07.013  PMID: 25046131 
  17. Mendes RE, Castanheira M, Farrell DJ, Flamm RK, Sader HS, Jones RN. Longitudinal (2001-14) analysis of enterococci and VRE causing invasive infections in European and US hospitals, including a contemporary (2010-13) analysis of oritavancin in vitro potency. J Antimicrob Chemother. 2016;71(12):3453-8.  https://doi.org/10.1093/jac/dkw319  PMID: 27609052 
  18. Ammerlaan HS, Harbarth S, Buiting AG, Crook DW, Fitzpatrick F, Hanberger H, et al. Secular trends in nosocomial bloodstream infections: antibiotic-resistant bacteria increase the total burden of infection. Clin Infect Dis. 2013;56(6):798-805.  https://doi.org/10.1093/cid/cis1006  PMID: 23223600 
  19. Gastmeier P, Schröder C, Behnke M, Meyer E, Geffers C. Dramatic increase in vancomycin-resistant enterococci in Germany. J Antimicrob Chemother. 2014;69(6):1660-4.  https://doi.org/10.1093/jac/dku035  PMID: 24615816 
  20. Remschmidt C, Schröder C, Behnke M, Gastmeier P, Geffers C, Kramer TS. Continuous increase of vancomycin resistance in enterococci causing nosocomial infections in Germany - 10 years of surveillance. Antimicrob Resist Infect Control. 2018;7(1):54.  https://doi.org/10.1186/s13756-018-0353-x  PMID: 29760912 
  21. Remschmidt C, Behnke M, Kola A, Peña Diaz LA, Rohde AM, Gastmeier P, et al. The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study. Antimicrob Resist Infect Control. 2017;6(1):95.  https://doi.org/10.1186/s13756-017-0253-5  PMID: 28924472 
  22. Elstrøm P, Astrup E, Hegstad K, Samuelsen Ø, Enger H, Kacelnik O. The fight to keep resistance at bay, epidemiology of carbapenemase producing organisms (CPOs), vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) in Norway, 2006 - 2017. PLoS One. 2019;14(2):e0211741.  https://doi.org/10.1371/journal.pone.0211741  PMID: 30716133 
  23. Pinholt M, Ostergaard C, Arpi M, Bruun NE, Schønheyder HC, Gradel KO, et al. , Danish Collaborative Bacteraemia Network (DACOBAN). Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009: a population-based cohort study. Clin Microbiol Infect. 2014;20(2):145-51.  https://doi.org/10.1111/1469-0691.12236  PMID: 23647880 
  24. Martischang R, Buetti N, Balmelli C, Saam M, Widmer A, Harbarth S. Nation-wide survey of screening practices to detect carriers of multi-drug resistant organisms upon admission to Swiss healthcare institutions. Antimicrob Resist Infect Control. 2019;8(1):37.  https://doi.org/10.1186/s13756-019-0479-5  PMID: 30809380 
  25. Salgado CD. The risk of developing a vancomycin-resistant Enterococcus bloodstream infection for colonized patients. Am J Infect Control. 2008;36(10):S175.e5-8.  https://doi.org/10.1016/j.ajic.2008.10.010  PMID: 19084155 
  26. Federal Office of Public Health (FOPH). Strategie Antibiotikaresistenzen Bereich Mensch. Liebefeld: FOPH; 2019. [Accessed 11 Jul 2019]. Available from: https://www.bag.admin.ch/bag/de/home/strategie-und-politik/nationale-gesundheitsstrategien/strategie-antibiotikaresistenzen-schweiz.html
  27. Flokas ME, Karageorgos SA, Detsis M, Alevizakos M, Mylonakis E. Vancomycin-resistant enterococci colonisation, risk factors and risk for infection among hospitalised paediatric patients: a systematic review and meta-analysis. Int J Antimicrob Agents. 2017;49(5):565-72.  https://doi.org/10.1016/j.ijantimicag.2017.01.008  PMID: 28336313 
  28. Harbarth S, Cosgrove S, Carmeli Y. Effects of antibiotics on nosocomial epidemiology of vancomycin-resistant enterococci. Antimicrob Agents Chemother. 2002;46(6):1619-28.  https://doi.org/10.1128/AAC.46.6.1619-1628.2002  PMID: 12019066 
  29. Federal Office of Public Health (FOPH) and Federal Food Safety and Veterinary Office. Swiss Antibiotic Resistance Report 2018. Usage of Antibiotics and Occurrence of Antibiotic Resistance in Bacteria from Humans and Animals in Switzerland. Liebefeld: FOPH; November 2018. Report No.: 2018-OEG-87.
  30. Vuichard-Gysin D, Schlegel M, Troillet N, Senn L, Marschall J, Blanc D, et al. Temporary expert guidance for healthcare institutions to contain the spread of vancomycin resistant enterococci (VRE) in Switzerland, Version 1.0 2018. [Accessed 11 Jul 2019]. Available from: https://www.swissnoso.ch/fileadmin/swissnoso/Dokumente/1_Swissnoso_allgemein/180912_Temporary_expert_guidance_for_healthcare_institutions_to_contain_the_spread_of_VRE_final_1.0.pdf.
  31. Dargère S, Cormier H, Verdon R. Contaminants in blood cultures: importance, implications, interpretation and prevention. Clin Microbiol Infect. 2018;24(9):964-9.  https://doi.org/10.1016/j.cmi.2018.03.030  PMID: 29621616 
  32. Kirn TJ, Weinstein MP. Update on blood cultures: how to obtain, process, report, and interpret. Clin Microbiol Infect. 2013;19(6):513-20.  https://doi.org/10.1111/1469-0691.12180  PMID: 23490046 
Increasing proportion of vancomycin resistance among enterococcal bacteraemias in Switzerland: a 6-year nation-wide surveillance, 2013 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Vanja+Piezzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Piezzi Vanja</a>, <a href="/search?value1=Michael+Gasser&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gasser Michael</a>, <a href="/search?value1=Andrew+Atkinson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Atkinson Andrew</a>, <a href="/search?value1=Andreas+Kronenberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kronenberg Andreas</a>, <a href="/search?value1=Danielle+Vuichard-Gysin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vuichard-Gysin Danielle</a>, <a href="/search?value1=Stephan+Harbarth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Harbarth Stephan</a>, <a href="/search?value1=Jonas+Marschall&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marschall Jonas</a>, <a href="/search?value1=Niccol%C3%B2+Buetti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Buetti Niccolò</a>, <a href="/search?value1=on+behalf+of+the+Swiss+Centre+for+Antibiotic+Resistance+%28ANRESIS%29&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Swiss Centre for Antibiotic Resistance (ANRESIS)</a>, <a href="/search?value1=on+behalf+of+the+National+Centre+for+Infection+Control+%28Swissnoso%29&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the National Centre for Infection Control (Swissnoso)</a></span>. Increasing proportion of vancomycin resistance among enterococcal bacteraemias in Switzerland: a 6-year nation-wide surveillance, 2013 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(35):pii=1900575. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.35.1900575" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.35.1900575</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Sept 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Feb 2020 </span> </p>
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