Stool carriage, clinical isolation, and mortality during an outbreak of vancomycin-resistant enterococci in hospitalized medical and/or surgical patients

Clin Infect Dis. 1995 Jul;21(1):45-50. doi: 10.1093/clinids/21.1.45.


During a nosocomial outbreak of infection due to vancomycin-resistant enterococci (VRE), rectal swabs that were collected weekly were used to identify and isolate VRE carriers. Over 6 months, 1,458 stool specimens from 724 high-risk patients were cultured, and 187 VRE isolates were recovered from 61 patients; 96% of the isolates were Enterococcus faecium. VRE tended to be isolated from clinical specimens from patients identified as VRE carriers by stool surveillance (P < .01). However, isolation of VRE from surveillance cultures preceded clinical isolation for only approximately 50% of the patients from whom a clinical VRE isolate was recovered. Mortality was greater (P < .05) among patients from whom a clinical VRE isolate was recovered than among patients from whom VRE was isolated only by stool surveillance. The mortality (1[17%] of 6) among patients for whom VRE was isolated from blood was similar to that (10 [27%] of 37) among patients for whom vancomycin-susceptible enterococcus was isolated from blood (P = .97). Despite prompt initiation of contact precautions for VRE carriers, the incidence of fecal carriage of VRE remained approximately 8% among this patient population for the 6-month period of the study.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Child
  • Critical Care
  • Cross Infection / microbiology
  • Cross Infection / mortality*
  • Disease Outbreaks*
  • Drug Resistance, Microbial
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification
  • Enterococcus faecium / drug effects
  • Enterococcus faecium / isolation & purification
  • Feces / microbiology
  • Female
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / mortality*
  • Hospitalization
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Minnesota / epidemiology
  • Vancomycin / pharmacology*


  • Anti-Bacterial Agents
  • Vancomycin