title: Control of endemic glycopeptide-resistant enterococci.
abstract: OBJECTIVE
  To evaluate the epidemiology of, and control measures for, vancomycin-resistant Enterococcus (VRE) in a renal unit.
  
  
  METHODS
  A 3-month, prospective, prevalence culture survey of patients on a 24-bed renal unit.
  
  
  METHODS
  A 975-bed community teaching hospital.
  
  
  METHODS
  Patients admitted to the renal unit over a 3-month period. Patients identified with VRE were each matched with four patients without VRE isolated over the study period. INTERVENTIONS/CONTROL MEASURES: Resistant-organism barrier precautions. To eradicate carriage of VRE, two patients with VRE stool colonization were treated with 5 days of oral doxycycline (100 mg twice per day) and rifampin (300 mg/day).
  
  
  RESULTS
  Seven patients with VRE (8 isolates) were identified. Five isolates were Enterococcus faecium (vancomycin MIC = 16 to 256 micrograms/mL), two were Enterococcus faecalis (MICs = 16 and 124 micrograms/mL), and one was Enterococcus gallinarum (MIC = 8.0 micrograms/mL). Eradication of carriage with VRE was accomplished in two patients treated with doxycycline and rifampin. In the final 30 days of the culture survey and at 9 months, there were no further patients with VRE identified.
  
  
  CONCLUSIONS
  Resistant-organism precautions and elimination of patient carriage may be useful measures for controlling the spread of low-prevalence endemic vancomycin-resistant Enterococcus.
authors.affiliation: Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Dembry
authors.forename: K
authors.initials: K
authors.lastname: Uzokwe
authors.forename: M J
authors.initials: MJ
authors.lastname: Zervos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016022:Case-Control Studies; D003428:Cross Infection / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D013293:Enterococcus faecalis; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014640:Vancomycin
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin