Acquisition of vancomycin-resistant enterococci in internal medicine wards.
BACKGROUND
Our institution experienced an increase in the frequency of vancomycin-resistant enterococci (VRE) clinical isolates, which rose 5-fold from 2004 to 2005. We sought to measure the prevalence of VRE carriage among medical inpatients in a tertiary hospital in Jerusalem and estimate the rate of acquisition during hospitalization.


METHODS
During 2006, we performed 3 cross-sectional surveys, including 1039 patients, representing 3 phases of hospitalization: admission, hospital stay, and discharge. Perianal/stool samples were cultured for VRE.


RESULTS
VRE carriage was 3.8% (95% confidence interval [CI] = 1.8% to 6.9%) on admission, 15% (95% CI = 9% to 23%) at discharge, and 32% (95% CI = 24% to 40%) among inpatients. Among inpatient carriers, 60% of the isolates represented a single strain. Recent previous hospitalization was the most significant predictor for identifying carriers on admission.


CONCLUSIONS
Our study demonstrates that substantial VRE transmission occurred during hospitalization. Identification of carriers on admission should supplement effective application of infection control methods in attempting to decrease VRE nosocomial spread and burden.
Cohen
Matan J
MJ
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Adler
Amos
A
Block
Colin
C
Gross
Ilana
I
Minster
Naomi
N
Roval
Varda
V
Tchakirov
Rachel
R
Moses
Allon E
AE
Benenson
Shmuel
S
D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D016983:Enterococcus / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000382:microbiology; D015995:Prevalence