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Patient colonization and environmental contamination by vancomycin-resistant enterococci in a rehabilitation facility
William E Trick1, Randy S Temple, David Chen
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. wbt9@cdc.gov
Objectives:
To determine the frequency of environmental contamination in patient and common-use rooms and patient colonization by vancomycin-resistant enterococci (VRE).
Design:
Cross-sectional study.
Setting:
A 146-bed rehabilitation facility.
Participants:
Rectal cultures were collected from 74 (80%) of 93 patients. Environmental cultures were obtained from surfaces in 15 patient rooms (5 floors) and common-use areas on 8 floors.
Interventions:
Not applicable.
Main Outcome Measures:
Gastrointestinal colonization of patients and environmental contamination of surfaces by VRE.
Results:
VRE was detected from 13 (18%) of 74 patients and 32 (10%) of 319 surfaces. The frequency of positive environmental cultures varied by location; cultures were more likely to be positive in patient rooms (15%), followed by common areas on patient floors (9%) and common areas separate from patient floors (1.3%). Surfaces were more likely to be positive in rooms with a VRE-colonized patient (24%), compared with rooms in which patient colonization status was unknown (13%, P=.13) or the patient was not colonized (0%, P=.002). Surfaces were more likely to be contaminated in a room that housed an incontinent compared with continent patients (22% vs 7%, P=.01).
Conclusions:
Although environmental contamination by VRE was common in patient rooms, contamination of common-use areas separate from patient floors was infrequent. Despite use of common-use areas by colonized patients, isolation practices at this facility appear to have minimized environmental surface contamination in these areas.