Risk Factors for Colonization of Vancomycin-Resistant Enterococci in Patients in the Intensive Care Unit: A single-center Retrospective Study

Background: Patients colonised with vancomycin-resistant enterococci (VRE) remain a problem worldwide, especially in intensive care units (ICU), necessitating the identification of associated risk factors. Understanding these factors is crucial for implementing effective infection control measures. The aim of this single-centre retrospective study was to determine the risk factors for VRE colonisation in patients admitted to medical and surgical ICUs. Methods: We analyzed data from 190 patients admitted to the ICUs between January 2020 and December 2022. Demographic information, clinical characteristics, laboratory results, antimicrobial usage, and comorbidities were obtained from digital patient records. Rectal swabs were collected weekly within 48 hours of ICU admission to detect VRE colonization. Independent risk factors causing VRE colonisation were determined by logistic regression analyses. Results: Out of 190 patients, 54 were colonized with VRE. Significant independent risk factors for VRE colonization included higher APACHE II scores on ICU admission (OR: 1.26, 95% CI: 1.03-1.55, p=0.024), longer hospital stay (OR: 1.25, 95% CI: 1.14-1.36, p<0.001), non-abdominal surgery (OR: 22.85, 95% CI: 6.90-75.72, p<0.001), and use of teicoplanin in the past three months (OR: 14.47, 95% CI: 4.55-46.03, p<0.001). VRE-colonized patients had lower mean C-reactive protein and albumin levels than non-VRE patients. Conclusion: Higher APACHE II scores, prolonged hospital stays, non-abdominal surgeries, and recent teicoplanin use are significant risk factors for VRE colonization in ICU patients. These findings indicate the importance of infection control strategies and antimicrobial stewardship programmes needed to reduce the spread of VRE in ICUs.