Prevalence of vancomycin-resistant enterococci (VRE) in U.S. hospitals is estimated to be roughly 12 percent on average across all hospital patients (McDonald 2006) and according to the CDC is more than 28 percent in intensive care units (CDC 2004). VRE rates in the United States and other countries are shown in  Figure 1.5. In Europe, only Portugal had a higher prevalence of VRE than did the United States. Data on VRE prevalence outside Europe are less reliable but show lower rates than the United States, with the exception of South Korea. Reliable studies from Japan have found isolated outbreaks but no evidence of VRE transmission (Arakawa, Ike et al. 2000; Matsumoto, Muratani et al. 2004).