Patient colonization and environmental contamination by vancomycin-resistant enterococci in a rehabilitation facility

Objectives: To determine the frequency of environmental contamination in patient and common-use rooms and patient colonization by vancomycin-resistant enterococci (VRE). Design: Cross-sectional study. Setting: A 146-bed rehabilitation facility. Participants: Rectal cultures were collected from 74 (80%) of 93 patients. Environmental cultures were obtained from surfaces in 15 patient rooms (5 floors) and common-use areas on 8 floors. Interventions: Not applicable. Main Outcome Measures: Gastrointestinal colonization of patients and environmental contamination of surfaces by VRE. Results: VRE was detected from 13 (18%) of 74 patients and 32 (10%) of 319 surfaces, The frequency of positive environmental cultures varied by location; cultures were more likely to be positive in patient rooms (15%), followed by common areas on patient floors (9%) and common areas separate from patient floors (1.3%). Surfaces were more likely to be positive in rooms with a VRE-colonized patient (24%), compared with rooms in which patient colonization status was unknown (13%, P=.13) or the patient was not colonized (0%, P=.002). Surfaces were more likely to be contaminated in a room that housed an incontinent compared with continent patients (22% vs 7%, P=.01). Conclusions: Although environmental contamination by VRE was common in patient rooms, contamination of common-use areas separate from patient floors was infrequent. Despite use of common-use areas by colonized patients, isolation practices at this facility appear to have minimized environmental surface contamination in these areas.