Major articleVancomycin-resistant Enterococcus colonization before admission to the intensive care unit: A clinico-epidemiologic analysis
Section snippets
Patients and study design
The Korea University Guro Hospital, located in southwestern Seoul, is a 650-bed tertiary care hospital with a 35-bed medical and surgical ICU. We performed a prospective observational study to estimate the prevalence of VRE colonization among inpatients at the time they were admitted to this ICU. From March to December 2007, we obtained rectal swab cultures within 48 hours of ICU admission to detect VRE colonization that had occurred prior to the ICU entrance of each patient. Patients who
Results
Of the 1276 patients admitted to the ICU during the 10-month study period, 780 remained there for more than 48 hours and were therefore eligible for this study. We found that 34 out of 780 patients (4.4%) were already colonized with VRE upon ICU admission: 6.5% (21 out of 323 patients) were transferred from general wards, and 2.97% (13 out of 437 patients) were from outside of the hospital (Fig 1). We isolated 33 E faecium and 1 E faecalis strains, all of which carried the vanA gene. In
Discussion
This study was designed to evaluate prior VRE colonization rates and their clinical significance among acutely ill patients entering the ICU of a large tertiary hospital. The overall colonization rate was 4.4%, lower than rates previously reported by Ostrowsky et al11 and Bonten et al12 in the mid-1990s. Ostrowsky et al11 reported that VRE colonization had already occurred in 12% of patients (35 out of 290) at the time of surgical ICU admission. This high prevalence of colonization compared
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Conflict of interest: All authors report no conflicts of interest.