title: Recovery of vancomycin-resistant enterococci on fingertips and environmental surfaces.
abstract: OBJECTIVE
  To determine the recovery of vancomycin-resistant enterococci (VRE) on fingertips, gloved fingertips, and environmental surfaces commonly encountered in the healthcare setting, and to examine the importance of handwashing on the removal of these organisms.
  
  
  METHODS
  Two clinical isolates of VRE (Enterococcus faecalis and Enterococcus faecium) were inoculated onto the hands of healthy human volunteers and the following environmental surfaces: countertops, bedrails, telephones, and stethoscopes. Following inoculation, samples were obtained at various time intervals to determine rates of recovery of organisms. To evaluate the effects of handwashing on enterococcal recovery, two different soap preparations were tested. Hands were washed with water alone or with one of the soaps and water. The soap and water studies were performed with a 5-second and a 30-second wash.
  
  
  RESULTS
  Both enterococcal strains survived for at least 60 minutes on gloved and ungloved fingertips. The E faecalis was recoverable from countertops for 5 days; the E faecium persisted for 7 days. For bedrails, both enterococcal species survived for 24 hours without significant reduction in colony counts. The bacteria persisted for 60 minutes on the telephone handpiece and for 30 minutes on the diaphragmatic surface of the stethoscope. A 5-second wash with water alone resulted in virtually no change in recovery of enterococci; a 30-second wash with water plus either soap was necessary to eradicate the bacteria from hands completely.
  
  
  CONCLUSIONS
  VRE are capable of prolonged survival on hands, gloves, and environmental surfaces. Hands should be washed thoroughly and gloves removed following contact with patients infected or colonized with these multidrug-resistant bacteria. Finally, environmental surfaces may serve as potential reservoirs for nosocomial transmission of VRE and need to be considered when formulating institutional infection control policies.
authors.affiliation: Department of Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Noskin
authors.forename: V
authors.initials: V
authors.lastname: Stosor
authors.forename: I
authors.initials: I
authors.lastname: Cooper
authors.forename: L R
authors.initials: LR
authors.lastname: Peterson
mesh_terms: D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification*; D013293:Enterococcus faecalis / Q000187:drug effects / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification; D004783:Environmental Microbiology; D004866:Equipment Contamination; D005385:Fingers / Q000382:microbiology*; D005932:Gloves, Surgical; D006235:Hand Disinfection; D006801:Humans; D013048:Specimen Handling; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D014640:Vancomycin