Background: We report on two endemic outbreaks of VRE (vancomycin-resistant enterococci, vanA type Ente-rococcus faecium) on a hematological oncology ward in a university hospital and a new strategic concept to fight against spread of VRE. Patients and Methods: During management of the outbreak, a total of 1,124 patients and 1,700 specimens were investigated from June 1999 to December 2001. Protective measures were instituted. Intensive prophylactic infection control was practiced until December 2003. Results: Of the 1,124 patients,44 were VRE-positive. From 1,700 environment speci-mens,110 VRE isolates were obtained from the inani-mate environment, 5 from the living environment. Mole-cular biological typing identified 5 different clones which had spread on the ward in different locations. Conclu-sion:The study shows the need for prophylactic microbi-ological screening investigations in the risk group of hematological oncology patients and consistent imple-mentation of protective hygiene measures to prevent the spread of multiresistant infectious pathogens on risk wards. It is also shown that intervention can to control such an endemic outbreak.

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