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Table 1 Overview of dates, isolation and screening policies per phase and risk group during VREfm outbreak period

From: Management of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in a Dutch general hospital, 2014–2017: successful control using a restrictive screening strategy

Risk group Definition Phase 1
Dec 14, 2015–Mar 20, 2016
Phase 2
Mar 21, 2016–Nov 13, 2016
Phase 3
Nov 14, 2016–Feb 5, 2017
Identification strategy Contact precautions Identification strategy Contact precautions Identification strategy Contactprecautions
VRE carrier Patient infected or colonised with VREfm N/A Yesa N/A Yesa N/A Yesa
VRE suspected All patients with prior hospitalisation in the ADRZ hospital location Goes from September 1, 2014 until start of zero transmission period Single rectal swab on admission Yes, while awaiting result of single admission screening Single rectal swab on admission No Single rectal swab on admission No
  Patients transferred from nursing homes or rehabilitation centres Single rectal swab on admission Yes, while awaiting result of single admission screening Single rectal swab on admission No No No
  Roommate of unexpected VRE carrier N/A Yesc 3 separate rectal cultures (collection at day 3, 5 and 7 after the last exposure) Yesa 3 separate rectal cultures (collection at day 3, 5 and 7 after the last exposure) Yesa
All patients (incl. low risk) Hospital wide surveillance Weekly screening of all patients hospitalised > 2 daysb N/A Weekly screening of all patients hospitalised > 2 days N/A Monthly screening of all patients hospitalised > 2 days N/A
  1. aSingle room or cohorting with other VRE carriers if insufficient availability of single rooms
  2. bIn high risk departments (dialysis and ICU) all admitted patients are screened, regardless of the admission time
  3. cAfter cleaning of the ward was completed, patients were separated int two cohorts: clean (new admissions not fulfilling the criteria of ‘VRE suspected’), and VRE suspected, each with dedicated staff. Contact precaution (CP) policy: Single room or—if single room was not available—cohort CP of patients with same VRE status on multi occupancy room. Healthcare workers wear gown with long sleeves and gloves before each contact with the patient or the patient environment. Rooms were daily cleaned, medical devices were cleaning and disinfected (alcohol 70%) before leaving the room, and after patient discharge, the room is cleaned and disinfected (250 ppm chlorine)
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