title: Vancomycin-resistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay.
abstract: 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.
authors.affiliation: Stratton Veterans Affairs Medical Center, Albany, NY 12208, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Rafferty
authors.forename: M I
authors.initials: MI
authors.lastname: McCormick
authors.forename: L H
authors.initials: LH
authors.lastname: Bopp
authors.forename: A L
authors.initials: AL
authors.lastname: Baltch
authors.forename: M
authors.initials: M
authors.lastname: George
authors.forename: R P
authors.initials: RP
authors.lastname: Smith
authors.forename: C
authors.initials: C
authors.lastname: Rheal
authors.forename: W
authors.initials: W
authors.lastname: Ritz
authors.forename: D
authors.initials: D
authors.lastname: Schoonmaker
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin