Why is transmission of vancomycin-resistant enterococci on the increase?

Nosocomial infections continue to escalate in response to antibiotic usage and breaches in infection control practices. Historically, naturally occurring bacteria that cause infection when present in an unfamiliar environment have been successfully treated with antibiotics. However, antibiotic resistance has kept ahead of antibiotics and creates a situation in which infection no longer responds to antibiotics. In the (hypothetical) case presented in this article, a person entering a hospital for a simple procedure may acquire a nosocomial infection, with a resulting increase in morbidity and mortality. Reservoirs of enterococci naturally occur in animals and humans, although the misuse of antibiotics in humans and animals has given rise to enterococci resistance, namely vancomycin-resistant enterococci. Once established in these reservoirs, vancomycin-resistant enterococci are easily transmitted by direct or indirect mechanisms and are proving difficult to control in hospitals, other healthcare settings, and in the community.