title: Patients in long-term care facilities: a reservoir for vancomycin-resistant enterococci.
abstract: A prospective cohort study with culture surveys and chart reviews was conducted to determine the prevalence of rectal colonization with vancomycin-resistant enterococci (VRE) and to identify risk factors for colonization among 100 residents of 20 different long-term care facilities (LTCFs) who were admitted to 2 medical wards of an academic acute care hospital. On admission to the hospital, 45 (45%) of these 100 patients were determined to be harboring VRE. Prior use of antibiotics and the presence of a decubitus ulcer were identified as risk factors. Fourteen other LTCF residents-33% of those at risk-acquired VRE in the hospital. Antecubital skin colonization with VRE was detected in 28% of patients. Hospital ward surveillance revealed a 60% mean point prevalence of VRE colonization among patients in LTCFs, compared with 21% for other patients (P<.001). Patients in LTCFs in urban referral hospitals are a major reservoir for VRE, which can be transmitted to other inpatients in the hospital, in the LTCF, and in smaller community hospitals.
authors.affiliation: Section of Infectious Diseases, Rush Medical College, and Division of Infectious Diseases, Cook County Hospital, Chicago, IL, USA.
authors.forename: Marnie L
authors.initials: ML
authors.lastname: Elizaga
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
authors.forename: Mary K
authors.initials: MK
authors.lastname: Hayden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003428:Cross Infection; D004197:Disease Reservoirs; D016983:Enterococcus / Q000187:drug effects / Q000502:physiology*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020713:Vancomycin Resistance / Q000502:physiology*