title: Community dissemination of vancomycin-resistant Enterococcus faecium.
abstract: OBJECTIVE
  In the United States, vancomycin-resistant enterococci (VRE) are predominantly acquired in the hospital. The extent of dissemination of VRE into the community in the United States has not been examined. Our objective was to determine the prevalence of VRE among nonhospitalized patients.
  
  
  METHODS
  We conducted a cross-sectional surveillance study in an ambulatory care clinic. One hundred ambulatory patients participated in the study. Measurements included a written questionnaire on patient demographics, clinical data, and prior exposure to health care settings and antibiotics; rectal swabs; pulsed-field gel electrophoresis; and polymerase chain reaction genotyping.
  
  
  RESULTS
  Three of 100 subjects (3%) were colonized with VRE, including one person who did not have any exposure to a health care setting or antibiotics.
  
  
  CONCLUSIONS
  VRE was recovered from nonhospitalized patients. Physicians should be alert to the potential of VRE transmission in the ambulatory care setting.
authors.affiliation: Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: D'Agata
authors.forename: J
authors.initials: J
authors.lastname: Jirjis
authors.forename: C
authors.initials: C
authors.lastname: Gouldin
authors.forename: Y W
authors.initials: YW
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D017714:Community-Acquired Infections / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D016521:Electrophoresis, Gel, Pulsed-Field; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013714:Tennessee / Q000453:epidemiology; D020713:Vancomycin Resistance