{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:44:10Z","timestamp":1753879450355,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Many institutions suspended surveillance and contact precautions for multidrug\u2010resistant organisms (MDROs) at the outset of the coronavirus disease 2019 (COVID\u201019) pandemic due to a lack of resources. Once our institution reinstated surveillance in September 2020, a vancomycin\u2010resistant <jats:italic>Enterococcus<\/jats:italic> (VRE) <jats:italic>faecium<\/jats:italic> outbreak was detected in the cardiothoracic transplant units, a population in which we had not previously detected outbreaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An outbreak investigation was conducted using pulsed\u2010field gel electrophoresis for strain typing and electronic medical record review to determine the clinical characteristics of involved patients. The infection prevention (IP) team convened a multidisciplinary process improvement team comprised of IP, cardiothoracic transplant nursing and medical leadership, environmental services, and the microbiology laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between December 2020 and March 2021, the outbreak involved thirteen patients in the cardiothoracic transplant units, four index cases, and nine transmissions. Of the 13, seven (54%) were on the transplant service, including heart and lung transplant recipients, patients with ventricular assist devices, and a patient on extracorporeal membrane oxygenation as a bridge to lung transplantation. Four of 13 (31%) developed a clinical infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Cardiothoracic surgery\/transplant patients may have a similar risk for VRE\u2010associated morbidity as abdominal solid organ transplant and stem cell transplant patients, highlighting the need for aggressive outbreak management when VRE transmission is detected. Our experience demonstrates an unintended consequence of discontinuing MDRO surveillance in this population and highlights a need for education, monitoring, and reinforcement of foundational infection prevention measures to ensure optimal outcomes.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid13972-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13972","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T12:19:10Z","timestamp":1664367550000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Vancomycin\u2010resistant <i>Enterococcus<\/i> outbreak in a pre\u2010 and post\u2010cardiothoracic transplant population: Impact of discontinuing multidrug\u2010resistant organism surveillance during the coronavirus disease 2019 pandemic"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-4095","authenticated-orcid":false,"given":"Shardul N.","family":"Rathod","sequence":"first","affiliation":[{"name":"Department of Healthcare Epidemiology and Infection Prevention Northwestern Memorial Hospital  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bardowski","sequence":"additional","affiliation":[{"name":"Department of Healthcare Epidemiology and Infection Prevention Northwestern Memorial Hospital  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Tse","sequence":"additional","affiliation":[{"name":"Cardiac, Vascular, and Thoracic Stepdown Northwestern Memorial Hospital  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei","family":"Churyla","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute Northwestern University Feinberg School of Medicine and Northwestern Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Fiehler","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute Northwestern University Feinberg School of Medicine and Northwestern Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Malczynski","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine, Clinical Microbiology Laboratory, Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine, Clinical Microbiology Laboratory, Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2641-5004","authenticated-orcid":false,"given":"Sajal D.","family":"Tanna","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Bulger","sequence":"additional","affiliation":[{"name":"Department of Environmental Services and Patient Escort Northwestern Memorial Hospital  Chicago Illinois 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