Preliminary Report: Prevalence of vancomycin-resistantEnterococcus faecalisin public restrooms in central Kentucky

Abstract

Enterococci are complex Gram positive cocci found in the intestines of humans and animals. For over 30 years, Enterococcus has shown increased resistance to vancomycin and other antimicrobials as seen in nosocomial infections in the United States. Vancomycin-resistant Enterococcus (VRE) in the community was first reported in the United States in 2010, but Europe has seen these organisms in the community for over 20 years. This study examined the prevalence of VRE in public restrooms from three locations in Woodford and Fayette counties in central Kentucky. Restrooms varied in size, location, and user type (male, female or unisex). The public restrooms tested were in a college auditorium, a college student center, a small cafe, and a hospital. Ninety-eight samples from eight restrooms were collected from surfaces including the door handle exiting the entire restroom, the lock on the stall door, the soap dispenser, the floor of the stall, the sink, the paper towel dispenser, the urinal, and the feminine napkin disposal system. Prevalence of Enterococcus faecalis, Enterococcus faecium and VRE was determined. Enterococcus species were identified by conventional biochemical physiologic testing, and vancomycin resistance was determined by the vancomycin agar screen test. VRE was isolated from four out of 98 (4%) of the samples collected. VRE was found on two exit door handles, one soap dispenser, and one feminine napkin disposal system. All of the VRE were found in hospital public (visitors') restrooms. VRE found in public restrooms may be a place for the possible spread of VRE to community members.