Colonization pattern of vancomycin-resistant Enterococcus faecium.
BACKGROUND
Vancomycin-resistant Enterococcus faecium is increasingly recognized as a serious problem by hospital epidemiologists. Understanding its colonization patterns may help in designing strategies to control its nosocomial spread in the hospital.


METHODS
Twenty patients, selected at random, with vancomycin-resistant E. faecium isolated from cultures of various body sites were studied to determine sites of colonization. For 12 of these patients, cultures of environmental surfaces of their rooms and wards were also obtained.


RESULTS
Eighteen patients (90%) had vancomycin-resistant E. faecium grown in stool cultures. In five patients (25%), vancomycin-resistant E. faecium was cultured from other sites: groins (four), popliteal fossae (three), mouth (one), and an open wound site (one). Patients with positive cultures from the groins and popliteal fossae also had growth of vancomycin-resistant E. faecium in cultures of diarrhea soiling those sites. No patients had the organism isolated from their nares. Vancomycin-resistant E. faecium grew in cultures obtained from bedside stand tables, over-bed tables, used linen, and bedside rails.


CONCLUSIONS
In the 20 patients studied, colonization of vancomycin-resistant E. faecium was limited chiefly to the enteric tract. Absence of colonization of such a secluded area with poor antibiotic penetrability as the nares is encouraging. In our study, vancomycin-resistant E. faecium was isolated from various environmental surfaces from the rooms and wards of patients with vancomycin-resistant E. faecium in their stools.
Yamaguchi
E
E
Infectious Disease Section, Department of Veterans Affairs Medical Center, East Orange, NJ 07108-1095.
Valena
F
F
Smith
S M
SM
Simmons
A
A
Eng
R H
RH
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology; D015169:Colony Count, Microbial; D004352:Drug Resistance, Microbial; D016984:Enterococcus faecium / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification*; D004783:Environmental Microbiology; D005243:Feces / Q000382:microbiology; D006119:Groin / Q000382:microbiology; D006801:Humans; D007275:Injections, Intravenous; D007422:Intestines / Q000382:microbiology; D009055:Mouth / Q000382:microbiology; D014640:Vancomycin / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D014640:Vancomycin