Yield of Vancomycin-Resistant Enterococci and Multidrug-Resistant Enterobacteriaceaefrom Stools Submitted for Clostridium difficileTesting Compared to Results from a Focused Surveillance Program

ABSTRACTIt has been suggested that a method of performing surveillance for vancomycin-resistant enterococci (VRE) is to screen specimens submitted for Clostridium difficiletesting. We compared this approach to our focused surveillance program of high-risk units during October 1997 to compare the yield of VRE and multidrug-resistantEnterobacteriaceae(MDRE) with both methods. Of the stools submitted for C. difficiletesting, 14% were positive for VRE or MDRE, whereas rectal swabs from routine surveillance yielded 11% VRE- or MDRE-positive results. Although stools submitted forC. difficiletesting resulted in a higher percentage of positive cultures, 14 VRE- and 2 MDRE-positive patients from our high-risk population were missed because many patients had no stool submitted for C. difficiletesting. Therefore, while screening stools submitted for C. difficiletesting cannot replace our focused surveillance program, it appears advantageous to assess these stools at various intervals to detect new patient reservoirs of drug-resistant organisms that may benefit from routine surveillance cultures.