Control of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region

During the past decade, vancomycin-resistant enterococci have emerged and become endemic at many health care facilities in the United States. 1 – 6 A major impediment to control is the large, unrecognized population of patients who are colonized with vancomycin-resistant enterococci and who thus can serve as a reservoir for transmission. 7 – 9 Colonization with vancomycin-resistant enterococci has been associated with progression to infection. 8 Studies suggest that once vancomycin-resistant enterococci are introduced in a facility, and particularly after they have spread to multiple patients or wards, control is very difficult. 6 – 8 Between December 1996 and April 1997, the number of isolates of vancomycin-resistant . . .