{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:19:00Z","timestamp":1783977540214,"version":"3.55.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"05","license":[{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X19000412_as1\"><jats:title>Objective:<\/jats:title><jats:p>We investigated the risk factors and origins of the first known occurrence of VRE colonization in the neonatal intensive care unit (NICU) at the Canberra Hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as2\"><jats:title>Design:<\/jats:title><jats:p>A retrospective case-control study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as3\"><jats:title>Setting:<\/jats:title><jats:p>A 21-bed neonatal intensive care unit (NICU) and a 15-bed special care nursey (SCN) in a tertiary-care adult and pediatric hospital in Australia.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as4\"><jats:title>Patients:<\/jats:title><jats:p>All patients admitted to the NICU and SCN over the outbreak period: January\u2013May 2017. Of these, 14 were colonized with vancomycin-resistant<jats:italic>Enterococcus<\/jats:italic>(VRE) and 77 were noncolonized.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as5\"><jats:title>Methods:<\/jats:title><jats:p>Demographic and clinical variables of cases and controls were compared to evaluate potential risk factors for VRE colonization. Whole-genome sequencing of the VRE isolates was used to determine the origin of the outbreak strain.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as6\"><jats:title>Results:<\/jats:title><jats:p>Swift implementation of wide-ranging infection control measures brought the outbreak under control. Multivariate logistic regression revealed a strong association between early gestational age and VRE colonization (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.94\u20137.00). Whole-genome sequencing showed the isolates to be highly clonal<jats:italic>Enterococcus faecium<\/jats:italic>ST1421 harboring a<jats:italic>vanA<\/jats:italic>gene and to be closely related to other ST1421 previously sequenced from the Canberra Hospital and the Australian Capital Territory.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19000412_as7\"><jats:title>Conclusion:<\/jats:title><jats:p>The colonization of NICU patients was with a highly successful clone endemic to the Canberra Hospital likely introduced into the NICU environment from other wards, with subsequent cross-contamination spreading among the neonate patients. Use of routine surveillance screening may have identified colonization at an earlier stage and have now been implemented on a 6-monthly schedule.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2019.41","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T10:29:14Z","timestamp":1552559354000},"page":"551-558","source":"Crossref","is-referenced-by-count":20,"title":["Vancomycin-resistant Enterococcus (VRE) outbreak in a neonatal intensive care unit and special care nursery at a tertiary-care hospital in Australia\u2014A retrospective case-control study"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2705-1847","authenticated-orcid":false,"given":"Patiyan","family":"Andersson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Beckingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire 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