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Further screening of patients on the ward was undertaken if any DDR1 ward screen was positive for VRE. Patients colonized with VRE were placed in isolation with contact precautions, with gloves but no gowns. Routine screening of patients on admission was not undertaken. Infection control procedures did not change throughout the duration of the study. Samples for anaerobic and aerobic blood culture were obtained by venipuncture with aseptic techniques or through a central venous device, and incubated in the BacT/ALERT blood culture system (bioM��rieux, Durham, NC, USA). Positive blood cultures were Gram-stained and subcultured onto horse blood agar, MacConkey agar, and chocolatized horse blood agar, and incubated at 35��C in 5% CO2. Identification and antibiotic susceptibility of isolates was performed with VITEK?2 Compact (bioM��rieux). Isolates were cultured on VRE screening plates with brain�Cheart infusion and Mueller�CHinton agar containing 6?��g/L vancomycin. In addition, multiplex PCR testing for the presence of vanA and vanB was performed on all enterococcal isolates. Testing for vanC with PCR was performed until August 2008, as this was found to be rare. During the study period, pulsed-field gel electrophoresis was performed when several patients were identified as having VRE on the same ward at the same time (Peel T, Cheng A, Spelman T, Huysmans M, Spelman D, unpublished data). These results consistently demonstrated significant diversity in restriction fragment length, with over selleck chemical 30 types being described at our institution, suggesting that VRE is an endemic, rather than an epidemic, problem. A data collection spreadsheet was designed to document potential risk factors for the development of enterococcal bacteraemia identified from a literature review (Table?S1). A single trained researcher (T.P.) obtained all additional information from careful review of each patient��s medical record. The demographic data for cases and controls were compared by using summary statistics. Descriptive analyses were based on percentages and frequencies for categorical variables, http://www.selleckchem.com/products/ABT-888.html and medians and interquartile ranges for continuous variables. Continuous variables were assessed for skew. Conditional logistic regression analysis was used to produce ORs with 95%?CIs for the association between each variable and the presence or absence of a VRE bacteraemia and VSE bacteraemia. Two multivariable models were generated. Multivariable conditional logistic regression techniques were used in assessment of risk factors, by adding, in forward substitution, factors identified as significant in the univariable analysis (p?