OBJECTIVE To explore the potential causes and the outcomes of prevention and control measures for an outbreak of vancomycin-resistant Enterococcus faecium (VRE-fm) hospital-associated infection among patients undergoing renal transplantation in a hospital.

METHODS An epidemiological survey and environmental hygiene testing were carried out for 5 patients with VRE-fm infection who were treated in the renal transplantation ward of urology department of the Affiliated Hospital of Inner Mongolia Medical University from Dec. 1, 2024 to Jun. 5, 2025. The targeted intervention measures were taken.

RESULTS Totally 5 of 27 hospitalized patients had infections in the renal transplantation ward of urology department of the hospital within a short period of time, with the infection rate 18.52%.The average age of the 5 infected patients was (43.26±2.97) years old, all of whom had a history of dialysis and postoperative immunosuppressant use. The clinical manifestations included 2 cases of incision infection and 4 cases of infectious diarrhea, with 1 patient dying from multiple organ failure secondary to infection. The sources of etiological specimens included drainage fluid, sputum and urine. Before intervention, the pass rate of environmental samples was 52.63% (10/19), and VRE was detected in 2 samples, with a detection rate of 10.53% (2/19). After intervention, the pass rate increased to 98.25% (56/57), and no target bacteria were detected, showing a statistically significant difference (P < 0.05). Drug susceptibility results showed that the 5 isolated VRE-fm strains were completely resistant to vancomycin and ampicillin, 4 strains were resistant to teicoplanin, penicillin and levofloxacin, 3 strains were resistant to erythromycin, 1 strain was resistant to tigecycline, and all strains were sensitive to linezolid.

CONCLUSIONS The outbreak of VRE-fm hospital-associated infection in this case is associated with multiple factors, including patients′ underlying conditions, unreasonable layout and processes, incomplete environmental cleaning and disinfection, inadequate hand hygiene practices and imperfect management mechanisms and systems. By implementing comprehensive measures such as strengthening environmental cleaning and disinfection, implementing contact isolation, standardizing hand hygiene and improving training, the spread of VRE-fm can be effectively controlled.