Routine Practices
Gram positive cocci in short chains
Nosocomial (esp. VRE), associated with prior antibiotics.
Colonization
More likely to cause true infection in immunocompromised or after selection pressure from antimicrobial administration has eliminated other organisms.
Bacteremia, endocarditis (usually subacute), intra-abdominal or hepatobiliary infection, UTI.
Use Routine Practices
Consult IPAC if isolate is resistant to vancomycin