title: Role of fecal incontinence in contamination of the environment with vancomycin-resistant enterococci.
abstract: BACKGROUND
  We tested the hypothesis that patients with vancomycin-resistant Enterococcus (VRE) stool colonization who are continent of feces contaminate the environment less frequently than patients who are colonized and incontinent.
  
  
  METHODS
  We prospectively examined the frequency of environmental VRE contamination in the rooms of 15 patients who were continent and 15 who were incontinent and VRE-colonized. Broth-enrichment cultures of bed rails, bedside table, and call buttons were performed at baseline, and 2 and 5 days after environmental disinfection. The numbers of VRE colonies isolated after directly plating environmental swabs onto agar were compared for the continent and incontinent groups.
  
  
  RESULTS
  The percentages of patients with 1 or more positive environmental cultures for VRE were not significantly different for the groups of patients who were continent and incontinent at baseline (60% vs 73%, P =.45) or 2 days after disinfection (60% vs 80%, P =.24). The numbers of VRE colonies isolated by direct plating were not significantly different for the continent and incontinent groups (P =.42).
  
  
  CONCLUSIONS
  Environmental contamination occurs frequently in the rooms of patients who are continent, and those who are incontinent and VRE-colonized. Our findings suggest that similar infection control measures should be implemented for patients who are continent and incontinent.
authors.affiliation: Division of Infectious Diseases, University Hospitals of Cleveland, Cleveland, Ohio, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mayer
authors.forename: Rula C
authors.initials: RC
authors.lastname: Geha
authors.forename: Marion S
authors.initials: MS
authors.lastname: Helfand
authors.forename: Claudia K
authors.initials: CK
authors.lastname: Hoyen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Donskey
mesh_terms: D016009:Chi-Square Distribution; D015169:Colony Count, Microbial; D016983:Enterococcus / Q000302:isolation & purification*; D004784:Environmental Monitoring / Q000379:methods*; D005242:Fecal Incontinence; D005243:Feces / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D011446:Prospective Studies; D020713:Vancomycin Resistance