Patient colonization and environmental contamination by vancomycin-resistant enterococci in a rehabilitation facility.
OBJECTIVE
To determine the frequency of environmental contamination in patient and common-use rooms and patient colonization by vancomycin-resistant enterococci (VRE).


METHODS
Cross-sectional study.


METHODS
A 146-bed rehabilitation facility.


METHODS
Rectal cultures were collected from 74 (80%) of 93 patients. Environmental cultures were obtained from surfaces in 15 patient rooms (5 floors) and common-use areas on 8 floors.


METHODS
Not applicable.


METHODS
Gastrointestinal colonization of patients and environmental contamination of surfaces by VRE.


RESULTS
VRE was detected from 13 (18%) of 74 patients and 32 (10%) of 319 surfaces. The frequency of positive environmental cultures varied by location; cultures were more likely to be positive in patient rooms (15%), followed by common areas on patient floors (9%) and common areas separate from patient floors (1.3%). Surfaces were more likely to be positive in rooms with a VRE-colonized patient (24%), compared with rooms in which patient colonization status was unknown (13%, P=.13) or the patient was not colonized (0%, P=.002). Surfaces were more likely to be contaminated in a room that housed an incontinent compared with continent patients (22% vs 7%, P=.01).


CONCLUSIONS
Although environmental contamination by VRE was common in patient rooms, contamination of common-use areas separate from patient floors was infrequent. Despite use of common-use areas by colonized patients, isolation practices at this facility appear to have minimized environmental surface contamination in these areas.
Trick
William E
WE
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. wbt9@cdc.gov
Temple
Randy S
RS
Chen
David
D
Wright
Marc O
MO
Solomon
Steven L
SL
Peterson
Lance R
LR
D003430:Cross-Sectional Studies; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D062665:Epidemiological Monitoring; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D012007:Rectum / Q000382:microbiology; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D020713:Vancomycin Resistance / Q000235:genetics