A silent outbreak of vancomycin-resistant Enterococcus faecium in a neonatal intensive care unit

Ronella Marom, Ronella Marom, Dror Mandel, Dror Mandel, Alon Haham, Alon Haham, Irit Berger, Irit Berger, Amit Ovental, Amit Ovental, Craig Raskind, Craig Raskind, Galia Grisaru-Soen, Galia Grisaru-Soen, Amos Adler, Amos Adler, Jonathan Lellouche, David Schwartz, Yehuda Carmeli, Yehuda CarmeliYehuda Carmeli, Vered Schechner, Vered Schechner

Research output: Contribution to journalArticlepeer-review


Objective: To describe the containment of a widespread silent outbreak of vancomycin-resistant Enterococcus faecium (VRE-fm) in the Tel-Aviv Medical Center (TASMC) neonatal intensive care unit (NICU). Methods: Setting - an NICU, participants - 49 cases of VRE-fm-colonized neonatal inpatients. Results: A newborn was transferred from the TASMC NICU to another hospital and screened positive for VRE-fm upon arrival. All TASMC NICU patients were then immediately screened for VRE and 21/38 newborns were identified as VRE carriers. Interventional measures were strictly enforced. By the end of the outbreak, 49 cases of VRE carriage had been identified. There were no VRE clinical infections. The source of the outbreak was not identified. Conclusion: Our study highlights the importance of screening implementation in a NICU setting since this outbreak could have been prevented by active screening of all out-born transfer patients and by having adopted mandatory screening into the NICU's routine procedures. Screening for multi-drug resistant organisms upon admission of all transferred patients to the NICU has been implemented.

Original languageEnglish
Article number87
JournalAntimicrobial Resistance and Infection Control
Issue number1
StatePublished - 16 Jun 2020


  • Infection
  • Neonatal intensive care unit
  • Neonate
  • Outbreak
  • Screening
  • Vancomycin-resistant Enterococcus faecium


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