Journal Article

Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci

Marnie L. Elizaga, Robert A. Weinstein and Mary K. Hayden

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 4, pages 441-446
Published in print February 2002 | ISSN: 1058-4838
Published online February 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/338461
Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci

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A prospective cohort study with culture surveys and chart reviews was conducted to determine the prevalence of rectal colonization with vancomycin-resistant enterococci (VRE) and to identify risk factors for colonization among 100 residents of 20 different long-term care facilities (LTCFs) who were admitted to 2 medical wards of an academic acute care hospital. On admission to the hospital, 45 (45%) of these 100 patients were determined to be harboring VRE. Prior use of antibiotics and the presence of a decubitus ulcer were identified as risk factors. Fourteen other LTCF residents—33% of those at risk—acquired VRE in the hospital. Antecubital skin colonization with VRE was detected in 28% of patients. Hospital ward surveillance revealed a 60% mean point prevalence of VRE colonization among patients in LTCFs, compared with 21% for other patients (P < .001). Patients in LTCFs in urban referral hospitals are a major reservoir for VRE, which can be transmitted to other inpatients in the hospital, in the LTCF, and in smaller community hospitals.

Journal Article.  3983 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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