Community dissemination of vancomycin-resistant Enterococcus faecium

Background and objective: In the United States, vancomycin-resistant enterococci (VRE) are predominantly acquired in the hospital. The extent of dissemination of VRE into the community in the United States has not been examined. Our objective was to determine the prevalence of VRE among nonhospitalized patients. Methods: We conducted a cross-sectional surveillance study in an ambulatory care clinic. One hundred ambulatory patients participated in the study. Measurements included a written questionnaire on patient demographics, clinical data, and prior exposure to health care settings and antibiotics; rectal swabs; pulsed-field gel electrophoresis; and polymerase chain reaction genotyping. Results: Three of 100 subjects (3%) were colonized with VRE, including one person who did not have any exposure to a health care setting or antibiotics. Conclusions: VRE was recovered from nonhospitalized patients. Physicians should be alert to the potential of VRE transmission in the ambulatory care setting.