Colonization and infection with multiple nosocomial pathogens among patients colonized with vancomycin-resistant Enterococcus.
OBJECTIVE
To test the hypothesis that patients colonized with vancomycin-resistant Enterococcus (VRE) have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE.


METHODS
A rectal swab culture survey was conducted to determine the point-prevalence of stool colonization with ceftazidime-resistant gram-negative bacilli in hospitalized patients with or without VRE stool colonization. For a 6-month period, the frequency of Clostridium difficile diarrhea and isolation of antibiotic-resistant (ie, ceftazidime-, piperacillin/tazobactam-, levofloxacin-, or trimethoprim/sulfamethoxazole-resistant) gram-negative bacilli, methicillin-resistant Staphylococcus aureus (MRSA), and non-albicans Candida species from clinical specimens other than stool was examined.


METHODS
A Department of Veterans Affairs medical center.


METHODS
All patients hospitalized in the acute care facility and one nursing home unit during a 1-week period in February 2001.


RESULTS
VRE-colonized patients had a higher point-prevalence of rectal colonization with ceftazidime-resistant gram-negative bacilli than did patients not colonized with VRE (17% vs 4%; P = .026). During a 6-month period,the VRE-colonized patients were more likely to have Clostridium difficile-associated diarrhea (26% vs 2%; P = .001), MRSA infection (17% vs 4%; P = .017), or colonization or infection with gram-negative bacilli resistant to 4 different antibiotics.


CONCLUSIONS
VRE-colonized patients in our institution have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE. This suggests that isolation measures implemented to control VRE could help limit the dissemination of other, coexisting pathogens.
Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio 44106, USA.
Curtis J
CJ
Donskey
Amy J
AJ
Ray
Claudia K
CK
Hoyen
Peter D
PD
Fuldauer
David C
DC
Aron
Ann
A
Salvator
Robert A
RA
Bonomo
D000368:Aged; D003428:Cross Infection / Q000635:transmission*; D016983:Enterococcus / Q000187:drug effects* / Q000472:pathogenicity*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D015995:Prevalence; D012007:Rectum / Q000382:microbiology*; D012307:Risk Factors; D020713:Vancomycin Resistance