PMID- 9154476
OWN - NLM
STAT- MEDLINE
DCOM- 19970812
LR  - 20190920
IS  - 0899-823X (Print)
IS  - 0899-823X (Linking)
VI  - 18
IP  - 5
DP  - 1997 May
TI  - Colonization with vancomycin-resistant Enterococcus faecium: comparison of a 
      long-term-care unit with an acute-care hospital.
PG  - 333-9
AB  - OBJECTIVE: To compare the epidemiology of vancomycin-resistant Enterococcus 
      faecium (VRE) in a long-term-care unit and an acute-care hospital. DESIGN: 
      Point-prevalence surveys for VRE rectal colonization of patients were carried out 
      over a 21-month period in patients in a long-term-care unit and an acute-care 
      hospital (medical ward and intensive-care units). The environment and hands of 
      healthcare workers also were sampled for VRE. Contour-clamped homogeneous 
      electric field (CHEF) electrophoresis was used to evaluate possible transmission 
      among roommates and the relatedness of patient strains to those in the 
      environment and on the hands of healthcare workers. SETTING: A 200-bed Veterans 
      Affairs Medical Center with an attached 90-bed long-term-care unit. RESULTS: From 
      December 1994 to January 1996, rectal VRE colonization of patients in the 
      long-term-care unit increased significantly from 9% to 22%. In contrast, patients 
      on the medical ward rarely were colonized after the first survey in December 
      1994, and only two intensive-care-unit patients were found to be colonized during 
      the four surveys. The environment was contaminated persistently in the 
      long-term-care unit. In the four surveys, carriage of VRE on hands of healthcare 
      workers varied from 13% to 41%; 65% of healthcare workers with VRE found on their 
      hands worked in the long-term-care unit. Seven different strains were identified 
      by CHEF typing. Although the initial survey found only vanA strains, subsequent 
      surveys showed vanB strains also were present. CONCLUSIONS: Residents of a 
      long-term-care unit frequently were colonized with VRE, but infections were 
      uncommon in this population. The environment of the long-term-care unit was 
      contaminated with VRE, and VRE was found frequently on the hands of healthcare 
      workers in this unit. Both vanA and vanB genotypes were found in this setting.
FAU - Bonilla, H F
AU  - Bonilla HF
AD  - Division of Infectious Diseases, Veterans' Affairs Medical Center, Ann Arbor, MI 
      48105, USA.
FAU - Zervos, M A
AU  - Zervos MA
FAU - Lyons, M J
AU  - Lyons MJ
FAU - Bradley, S F
AU  - Bradley SF
FAU - Hedderwick, S A
AU  - Hedderwick SA
FAU - Ramsey, M A
AU  - Ramsey MA
FAU - Paul, L K
AU  - Paul LK
FAU - Kauffman, C A
AU  - Kauffman CA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Infect Control Hosp Epidemiol
JT  - Infection control and hospital epidemiology
JID - 8804099
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - *Anti-Bacterial Agents
MH  - Chi-Square Distribution
MH  - Confidence Intervals
MH  - *Disease Reservoirs
MH  - *Drug Resistance, Microbial
MH  - Enterococcus/genetics/*isolation & purification
MH  - Environmental Exposure/*analysis
MH  - Equipment Contamination
MH  - Hand/microbiology
MH  - Hospital Bed Capacity, 100 to 299
MH  - Hospital Units/*statistics & numerical data
MH  - Hospitals, Veterans/statistics & numerical data
MH  - Humans
MH  - Long-Term Care
MH  - Longitudinal Studies
MH  - Michigan/epidemiology
MH  - Odds Ratio
MH  - Personnel, Hospital
MH  - Rectum/microbiology
MH  - Time Factors
MH  - *Vancomycin
MH  - Wounds and Injuries/microbiology
EDAT- 1997/05/01 00:00
MHDA- 1997/05/01 00:01
CRDT- 1997/05/01 00:00
PHST- 1997/05/01 00:00 [pubmed]
PHST- 1997/05/01 00:01 [medline]
PHST- 1997/05/01 00:00 [entrez]
AID - 10.1086/647621 [doi]
PST - ppublish
SO  - Infect Control Hosp Epidemiol. 1997 May;18(5):333-9. doi: 10.1086/647621.