Controlling the spread of vancomycin-resistant enterococci with a rehabilitation cohort unit

Enterococci are common to the human gastrointestinal tract. Recently there has been an emergence of vancomycin-resistant enterococci (VRE); infection requires strict contact isolation. Patients with VRE infections are at higher risk for morbidity and mortality. As a result of the high prevalence of VRE, it was recommended that a cohort unit be established to control its spread within our metropolitan community hospital. We report the development of a rehabilitation VRE cohort unit. We present case studies of five patients who developed nosocomial colonization and one with an infection with VRE; all were treated on the rehabilitation cohort unit. Protocols for VRE isolation and procedures for decontamination in the cohort unit were developed. If a cohort unit is necessary, it is feasible to conduct a rehabilitation program in a cohort unit with strict adherence to contact isolation.