The prevalence of colonization with vancomycin-resistant Enterococcus at aveterans' affairs institution

OBJECTIVE: To study vancomycin-resistant Enterococcus (VRE) prevalence, ris k factors, and clustering among hospital inpatients. DESIGN: Rectal-swab prevalence culture survey conducted from February 5 to March 22, 1996. SETTING: The Veterans' Affairs Medical Center, Atlanta, Georgia. PATIENTS: Hospital (medical and surgical) inpatients. RESULTS: The overall VRE prevalence was 29% (42/147 patients). The VRE prev alence was 52% (38/73 patients) among patients who had received at least on e of six specific antimicrobials during the preceding 120 days, compared wi th only 5% (4/74) among those who had not received the antimicrobials (rela tive risk, 9.6; P<.001). The longer the period (up to 120 days) during whic h antimicrobial use was studied, the more closely VRE status was predicted. Among 67 hospital patients in 28 multibed rooms, clustering of VRE among c urrent roommates was not found. CONCLUSIONS: At this hospital with relatively high VRE prevalence, VRE: col onization was related to antibiotic use but not to roommate VRE, status. In hospitals with a similar VRE epidemiology, obtaining cultures from roommat es of VRE-positive patients may not be as efficient a strategy for identify ing VRE-colonized patients as obtaining screening cultures from patients wh o have received antimicrobials.