Vancomycin-resistant enterococci among chronic hemodialysis patients: a prospective study of acquisition. Clin. Infect. Dis

To determine the prevalence and rate of acquisition of vancomycin-resistant enterococci (VRE) among patients undergoing chronic (i.e., long-term) hemodialysis who were admitted to a tertiary care center, serial rectal cultures for VRE were performed at hospital admission and every 5 days until hospital discharge. A total of 7 (6%) of the 119 patients were colonized with VRE at admission. Six (19%) of the 32 patients who remained in the hospital>4 days acquired VRE. A nonambulatory status was signi®cantly associated with colonization at admission (OR, 9.7; 95 % CI, 1.8±53;), and vancomycin exposure was signi®cantly associated withP p.01 VRE acquisition (relative risk, 1.8; 95 % CI, 1.1±2.9;). All patients acquired VRE from epidemiologicallyP p.02 linked dialysis patients colonized with similar VRE genotypes. Hospital acquisition of VRE contributes sub-stantially to the increasing prevalence of VRE in the chronic hemodialysis patient population. The percentage of hemodialysis centers in the United States reporting>1 patient colonized or infected with vancomycin-resistant enterococci (VRE) rose from 11% in 1995 to 21 % in 1996 [1]. Several factors unique to the dialysis population may contribute substantially to these rapidly rising rates. The proximity of patients i