Active surveillance reduces the incidence of vancomycin-resistant enterococcal bacteremia

Clin Infect Dis. 2003 Oct 1;37(7):921-8. doi: 10.1086/377733. Epub 2003 Sep 12.


The impact of active surveillance of patients at risk for infection with vancomycin-resistant enterococci (VRE) was examined, and VRE bacteremia rates and the degree of VRE clonality in 2 similar neighboring hospitals were compared. Hospital A did not routinely screen patients for VRE rectal colonization; hospital B actively screened high-risk patients. Retrospective observations were made over the course of 6 years, beginning when initial VRE bloodstream isolates were recovered at each institution. The rate of VRE bacteremia was 2.1-fold higher at hospital A, and the majority of hospital A isolates were clonally related: 4 clones were responsible for infection in >75% of patients with VRE bacteremia, and isolates from 30% of patients were from the most common clone. The 4 most common clones at hospital B were responsible for infection in 37% of patients, and isolates from 14.5% of patients were from the most common clone. Lower VRE bacteremia rates and a more polyclonal population, representing less horizontal transmission, may result from routine screening of patients who are at risk for VRE and prompt contact isolation of colonized individuals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / epidemiology*
  • Enterococcus / drug effects*
  • Female
  • Gram-Positive Bacterial Infections / epidemiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Safety Management
  • Vancomycin / pharmacology*
  • Vancomycin Resistance / physiology*


  • Vancomycin