Vancomycin-resistant Enterococci in Stool Specimens Submitted for Clostridium Difficile Cytotoxin Assay

Infect Control Hosp Epidemiol. 1997 May;18(5):342-4. doi: 10.1086/647623.


The prevalence of, and clinical risk factors associated with, vancomycin-resistant enterococcal colonization were investigated in patients suspected of having Clostridium difficile infection. Stools submitted for C difficile cytotoxin testing were screened for vancomycin-resistant enterococci (VRE). Isolates were speciated and characterized further by antibiotic susceptibility testing, DNA fingerprinting, and DNA:DNA hybridization for detection of specific vancomycin resistance genes. Of the 79 evaluable patients identified during a 3-month period, 16.5% were VRE-positive. The VRE isolates were genetically heterogeneous, although all carried the vanA gene. DNA fingerprinting data suggest that patient-to-patient transmission occurred, implicating colonized patients as potential reservoirs for VRE transmission. A positive C difficile cytotoxin assay and diabetes mellitus were the only identifiable risk factors associated with VRE colonization. Patients at risk for C difficile infection therefore may serve as reservoirs for VRE.

Publication types

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

MeSH terms

  • Anti-Bacterial Agents*
  • Clostridium difficile / chemistry*
  • Disease Reservoirs*
  • Disease Transmission, Infectious
  • Drug Resistance, Microbial
  • Enterococcus / genetics
  • Enterococcus / isolation & purification*
  • Feces / microbiology*
  • Humans
  • Inpatients / statistics & numerical data*
  • New York / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Vancomycin*


  • Anti-Bacterial Agents
  • Vancomycin