During the past 8 years, vancomycin-resistant enterococci have emerged as a major public health problem. Data from USA surveillance system hospitals show that the proportion of enterococci resistant to vancomycin continues to increase in both intensive care unit and non-intensive care unit patients. Internationally, vancomycin-resistant enterococci have been found in foodstuffs and in the gastrointestinal tracts of non-hospitalized persons in areas where avoparcin has been used as an animal feed additive. Although infection control recommendations have been shown to be effective, their incomplete implementation or adherence results in the continued transmission of vancomycin-resistant enterococci. The development of alternative control measures or more complete implementation of current recommendations is necessary if the transmission of vancomycin-resistant enterococci is to be reduced or terminated.
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