title: Prevalence of colonization with vancomycin-resistant enterococci in various population groups in Berlin, Germany.
abstract: In order to prevent the spread of vancomycin-resistant enterococci (VRE), the epidemiology of this micro-organism must be defined. The prevalence of colonization with VRE in various population groups in Berlin was investigated and the risk factors associated with VRE colonization assessed. In a cross-sectional study, rectal swabs were taken from seven population groups (healthy students, outpatients, home nursing patients, normal care and critical care patients of a community hospital and university hospital). Every one completed a questionnaire (age, gender, previous hospital stays, antibiotic therapy). Rectal swabs were examined for the presence of normal gut flora and VRE. All VRE isolates were typed by pulsed-field gel electrophoresis (PFGE). VRE colonization prevalence ranged from 0.9% (students) to 4.2% (nursing-home patients) in non-hospitalized subjects; in hospitalized patients prevalence ranged from 1.8% (regular care ward of a community hospital) to 16.3% (ICU patients of a university hospital). Location (university hospital, OR = 3.5) and age (> or = 60 years, OR = 2.2) were independent risk factors for VRE colonization. Within one population group, isolates with identical PFGE patterns were found in up to three people; one strain was found in four subjects belonging to different groups. Our findings suggest that VRE are imported from the community into hospitals with subsequent spread within the institution.
authors.affiliation: Institut für Hygiene, Umweltmedizin und Arbeitsmedizin, Freie Universität Berlin.
authors.forename: C
authors.initials: C
authors.lastname: Wendt
authors.forename: C
authors.initials: C
authors.lastname: Krause
authors.forename: L U
authors.initials: LU
authors.lastname: Xander
authors.forename: D
authors.initials: D
authors.lastname: Löffler
authors.forename: H
authors.initials: H
authors.lastname: Floss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000037:antagonists & inhibitors*; D015373:Bacterial Typing Techniques; D001604:Berlin / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014505:Urban Population / Q000706:statistics & numerical data; D014640:Vancomycin / Q000037:antagonists & inhibitors*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin