The Role of "Colonization Pressure" in the Spread of Vancomycin-Resistant Enterococci

Abstract

INFECTION CONTROL measures are key to preventing the spread of microorganisms within hospitals, especially in high-risk areas such as intensive care and transplant units. Hand washing is heralded as the single most important control measure, and effective hand-washing techniques have been shown to reduce the rate of nosocomial infections in several studies.^1,2 However, compliance with this basic function has been reported to be as low as 22% to 42%,^1-3 and achieving 100% hand-washing compliance is an elusive goal. Intensive antibiotic control programs also have been advocated as a means to decrease selective pressures that favor the emergence and persistence of antibiotic-resistant bacteria.^4,5 These programs have been successful in decreasing targeted antibiotic resistance rates for specific bacteria,⁴ but published reports are limited.