Abstract: OBJECTIVE To investigate 1 cluster incident of vancomycin-resistant Enterococcus faecium (VRE-fm) in intensive care unit (ICU) and formulate targeted prevention and control measures by finding out the infection sources and transmission routes so as to provide bases for precise prevention and control of VRE-fm. METHODS A epidemiological survey and environmental hygiene surveillance were conducted for 3 patients who were detected with VRE-fm in the ICU of Liuzhou People's Hospital in Jan. 2025. The major links of dissemination of the drug-resistant strains were observed, the effective intervention measures were formulated, and the effects on prevention and control of the strains were evaluated. RESULTS The mean age of the 3 patients who were detected with VRE-fm was (66.33±16.77) years old, their beds were adjacent to each other and had an intersection of the length of hospital stay and the diagnosis and treatment personnel, and 2 of them had the same result of antimicrobial susceptibility testing. 8 of the environmental samples were tested positive before the intervention, with the isolation rate 21.62%. The result of antimicrobial susceptibility testing indicated that there was cross contamination among the bed units; 2 samples were tested positive for the second environmental sampling after the intervention, with the isolation rate 2.56%, and no sample was tested positive for the third time, there was significant difference(P＜0.05). VRE-fm was not found on the hand surface samples from health care workers, but 1 doctor and 1 nurse were detected with excessive bacterial colony counts on their hands. Based on the clinical manifestations and retesting result of the patients, the patient of Bed 16 was diagnosed with specimen contamination, the patient of Bed 15 was diagnosed with VRE-fm colonization, and the patient of bed 14 was diagnosed with VRE-fm health care-associated infection (HAI). The nosocomial transmission of VRE-fm was effective under control after comprehensive intervention measures were taken. CONCLUSIONS The incident is an outbreak of VRE-fm clustering in the ICU and is closely associated with inadequate environmental cleaning and disinfection, poor compliance with hand hygiene, and deficiencies in management. The transmission chain of VRE-fm is successfully and promptly interrupted through comprehensive measures including enhancement of environmental cleaning and disinfection, single-room isolation, strict adherence to hand hygiene protocols, and multidisciplinary collaboration for prevention and control.