Vancomycin-resistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay.
The prevalence of, and clinical risk factors associated with, vancomycin-resistant enterococcal colonization were investigated in patients suspected of having Clostridium difficile infection. Stools submitted for C difficile cytotoxin testing were screened for vancomycin-resistant enterococci (VRE). Isolates were speciated and characterized further by antibiotic susceptibility testing, DNA fingerprinting, and DNA:DNA hybridization for detection of specific vancomycin resistance genes. Of the 79 evaluable patients identified during a 3-month period, 16.5% were VRE-positive. The VRE isolates were genetically heterogeneous, although all carried the vanA gene. DNA fingerprinting data suggest that patient-to-patient transmission occurred, implicating colonized patients as potential reservoirs for VRE transmission. A positive C difficile cytotoxin assay and diabetes mellitus were the only identifiable risk factors associated with VRE colonization. Patients at risk for C difficile infection therefore may serve as reservoirs for VRE.
Rafferty
M E
ME
Stratton Veterans Affairs Medical Center, Albany, NY 12208, USA.
McCormick
M I
MI
Bopp
L H
LH
Baltch
A L
AL
George
M
M
Smith
R P
RP
Rheal
C
C
Ritz
W
W
Schoonmaker
D
D
D000900:Anti-Bacterial Agents; D016360:Clostridioides difficile / Q000737:chemistry*; D004197:Disease Reservoirs; D018562:Disease Transmission, Infectious; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000235:genetics / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014640:Vancomycin
D000900:Anti-Bacterial Agents; D014640:Vancomycin