VANCOMYCIN-RESISTANT ENTEROCOCCI IN INTENSIVE-CARE HOSPITAL SETTINGS

Vancomycin-resistant enterococci (VRE) have recently emerged as a noso comical pathogen and present an increasing threat to the treatment of severely ill patients in intensive-care hospital settings. We outline results of a study of the epidemiology of VRE transmission in ICUs and define a reproductive number R-0; the number of secondary colonizatio n cases induced by a single VRE-colonized patient in a VRE-free ICU, f or VRE transmission. For VRE to become endemic requires R-0 > 1. We es timate that in the absence of infection control measured R-0 lies in t he range 3-4 in defined ICU settings. Once infection control measures are included R-0 = 0.6, suggesting that admission of VRE-colonized pat ients can stabilize endemic VRE.