Absence of vancomycin-resistant enterococci (VRE) despite the presence of risk factors: a survey of rectal carriage of VRE

Aim: The resistant organisms from patients and healthcare workers (HCWs) first colonized the gastrointestinal tract before causing infections in patients. In this study, presence of risk factors for vancomycin-resistant enterococci (VRE)colonization and the prevalence of rectal carriage of VRE among HCWs and hospitalized patients in the absence of an outbreak were investigated. Design: Cross-sectional study. Setting: A 600-bed training and research hospital. Materials and methods: A total of 508 intensive-care unit (ICU) patients and HCWs in these units were included. Risk factors such as previous antibiotic use, especially vancomycin and cephalosporin, the presence of invasive devices like catheters, and co-morbid diseases were investigated. Rectal smear cultures were obtained from each participant to detect VRE colonization. Results: Risk factors for VRE colonization were identified among both patients and HCWs with a significant ratio. Except for one patient, who had been transferred from another hospital, no VRE colonization was detected in patients or HCWs. Conclusion: The result was attributed to factors such as low inter-institutional transfer, HCWs’ being free of VRE colonization (transmission is less likely), strict infection control strategy of the hospital, isolation of newly transferred patients suspected of having VRE colonization, isolation of VRE colonization identified patients, use of indwelling catheters only when indicated and their early removal, and low prevalence of predisposing co-morbid diseases and malignity. We want to underline that a strict hospital infection control program can prevent colonization, even in the presence of risk factors.