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 6months, 1,458 stool specimens from 724 high-riskpatients were cultured, and 187 VRE isolates were recovered from 61 patients; 96% of the isolates were Enterococcus faecium. VRE tendedtobe 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 ∼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 isolatedonly by stool surveillance. The mortality (1 [17%] of 6) among patients for whom VREwas 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 ofVRE remained ∼8% among this patient population for the 6-month period of the study.
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Received 19 September 1994; revised 10 March 1995. The guidelines of the Human Subjects Office of the University ofMinnesota Institutional Review Board were followed in the conduct of this study. Financial support: This work was supported by the University of Minnesota Hospitals and Clinics and the National Institutes of Health (AI-23484). Reprints or correspondence: Dr. Carol L. Wells, Department of Laboratory Medicine and Pathology, Box 609 UMHC, University of Minnesota, Minneapolis, Minnesota 55455-0374.