Vancomycin-resistant Enterococcus faecium (VREfm) is a globally significant nosocomial pathogen with a rapidly increasing prevalence. The objectives were to investigate VREfm outbreak duration and study the additional impact that infection control bundle strategies (ICBSs) set up to curb coronavirus disease 2019 (COVID-19) spreading had on VREfm outbreaks. Outbreak data set were collected prospectively from April 2, 2014 to August 13, 2020 at Copenhagen University Hospital Bispebjerg, Denmark. All VREfm samples had polymerase chain reaction performed for vanA/vanB genes before whole genome sequencing using the Illumina MiSeq platform. The relatedness of isolates was studied by core genome multilocus sequence typing (cgMLST) using Ridom SeqSphere. Eighty-one outbreaks had a median outbreak duration of 32.5 days (range 5–204 days) and 1,161 VREfm isolates were sequenced. The same cgMLST cluster types reappeared after outbreaks were terminated. When comparing the first 5 months of the COVID-19 pandemic with the corresponding period in 2019, we found a 10-fold decrease in VREfm outbreak patients and median outbreak duration decreased from 56 to 7 days (88%). Several COVID-19 ICBSs were implemented from March 13 through summer 2020. VREfm outbreaks lasted up to 204 days, but our findings suggest that outbreaks might last longer since the same cgMLST persisted in the same wards for years implying an endemic situation with recurrent outbreaks caused by hospital reservoirs or readmittance of unknown VREfm carriers. The sharp decline in VREfm outbreaks during the COVID-19 pandemic was most likely due to the ICBSs, resulting in a decrease in VREfm transmission.

中文翻译：

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丹麦 COVID-19 封锁期间耐万古霉素粪肠球菌暴发持续时间和患者人数大幅减少：一项前瞻性观察研究

耐万古霉素屎肠球菌(VREfm) 是一种全球重要的医院内病原体，其流行率迅速增加。目的是调查 VREfm 爆发持续时间，并研究为遏制 2019 年冠状病毒病 (COVID-19) 传播而制定的感染控制包策略 (ICBS) 对 VREfm 爆发的额外影响。疫情数据集于 2014 年 4 月 2 日至 2020 年 8 月 13 日在丹麦哥本哈根大学医院 Bispebjerg 前瞻性收集。所有 VREfm 样品都对vanA / vanB进行了聚合酶链式反应使用 Illumina MiSeq 平台进行全基因组测序之前的基因。使用 Ridom SeqSphere 通过核心基因组多位点序列分型 (cgMLST) 研究分离物的相关性。81 起暴发的中位暴发持续时间为 32.5 天（范围 5-204 天），并对 1,161 个 VREfm 分离株进行了测序。在爆发终止后，相同的 cgMLST 簇类型再次出现。在将 COVID-19 大流行的前 5 个月与 2019 年同期进行比较时，我们发现 VREfm 暴发患者减少了 10 倍，中位暴发持续时间从 56 天减少到 7 天 (88%)。从 3 月 13 日到 2020 年夏天实施了几个 COVID-19 ICBS。VREfm 爆发持续了长达 204 天，但我们的研究结果表明，由于相同的 cgMLST 在同一个病房中持续多年，因此暴发可能持续更长时间，这意味着由医院水库或未知 VREfm 携带者重新入院引起的反复暴发的地方性情况。COVID-19 大流行期间 VREfm 爆发的急剧下降很可能是由于 ICBS，导致 VREfm 传播减少。