Figure 3.

Culture plate showing gross contamination of a call button with vancomycin-resistant Enterococcus (VRE) after completion of cleaning by housekeeping staff. The patient was a 68 year-old man with Clostridium difficile-associated disease and VRE intestinal colonization. A sterile, pre-moistened cotton-tipped swab was applied to the surface of the call button and directly plated onto Enterococcosel agar containing 20 μg per mL of vancomycin. The same call button yielded C. difficile by broth enrichment culture.