Prevalence of colonization with vancomycin-resistant enterococci in various population groups in Berlin, Germany

In order to prevent the spread of vancomycin-resistant enterococci (VRE), t he epidemiology of this micro-organism must be defined. The prevalence of c olonization with VRE in various population groups in Berlin was investigate d and the risk factors associated with VRE colonization assessed. In a cros s-sectional study, rectal swabs were taken from seven population groups (he althy students, outpatients, home nursing patients, normal care and critica l care patients of a community hospital and university hospital). Every one completed a questionnaire (age, gender, previous hospital stays, antibioti c therapy). Rectal swabs were examined for the presence of normal gut flora and VRE. All VRE isolates mere typed by pulsed-field gel electrophoresis ( PFGE). VRE colonization prevalence ranged from 0.9% (students) to 4.2% (nur sing-home patients) in non-hospitalized subjects; in hospitalized patients prevalence ranged from 1.8% (regular care ward of a community hospital) to 16.3% (ICU patients of a university hospital). Location (university hospita l, OR = 3.5) and age (greater than or equal to 60 years, OR = 2.2) were ind ependent risk factors for VRE colonization. Within one population group, is olates with identical PFGE patterns were found in up to three people; one s train was found in four subjects belonging to different groups. Our finding s suggest that VRE are imported from the community into hospitals with subs equent spread within the institution.