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Vancomycin-resistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay
M E Rafferty1, M I McCormick, L H Bopp
1Stratton Veterans Affairs Medical Center, Albany, NY 12208, USA.
Infection Control and Hospital Epidemiology
|May 1, 1997
Summary
Vancomycin-resistant enterococci (VRE) colonization affects 16.5% of patients with suspected Clostridium difficile infection. Diabetes and a positive C. difficile test are key risk factors for VRE, highlighting potential reservoirs for transmission.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Vancomycin-resistant enterococci (VRE) pose a significant healthcare challenge.
- Clostridium difficile infection (CDI) is a common hospital-acquired infection.
- Co-colonization of VRE and CDI warrants investigation of associated risk factors and transmission dynamics.
Purpose of the Study:
- To determine the prevalence of VRE colonization in patients with suspected CDI.
- To identify clinical risk factors associated with VRE colonization in this patient group.
- To investigate the genetic relatedness and potential transmission of VRE isolates.
Main Methods:
- Screening of stool samples for VRE in patients undergoing C. difficile cytotoxin testing.
- Speciation and antibiotic susceptibility testing of VRE isolates.
- DNA fingerprinting and DNA:DNA hybridization for genotypic characterization and vanA gene detection.
Main Results:
- 16.5% of the 79 evaluable patients were VRE-positive.
- VRE isolates were genetically diverse but all harbored the vanA gene.
- Patient-to-patient transmission of VRE was suggested by DNA fingerprinting.
- Positive C. difficile cytotoxin assay and diabetes mellitus were significant risk factors for VRE colonization.
Conclusions:
- Patients with suspected CDI are frequently colonized with VRE.
- VRE-colonized patients with CDI may act as reservoirs for VRE transmission.
- Targeted screening and infection control measures are crucial for VRE and CDI patients.