Research Article
Year 2025,
Issue: Kabul Edilen Makaleler
Abstract
References
- 1. Cairns KA, Udy AA, Peel TN, et al. Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections. Clin Microbiol Rev. 2023;36: e0005922. DOI: 10.1128/cmr.00059-22
- 2. Eichel VM, Last K, Brühwasser C, et al. Epidemiology and outcomes of vancomycin-resistant enterococcus infections: a systematic review and meta-analysis. J Hosp Infect. 2023;141: 119–128. DOI: 10.1016/j.jhin.2023.09.008
- 3. Tacconelli E, Cataldo MA. Vancomycin-resistant enterococci (VRE): transmission and control. Int J Antimicrob Agents. 2008;31: 99–106. DOI: 10.1016/j.ijantimicag.2007.08.026
- 4. Elizaga ML, Weinstein RA, Hayden MK. Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci. Clin Infect Dis. 2002;34: 441–446. DOI: 10.1086/338461
- 5. Karki S, Houston L, Land G, et al. Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study. Antimicrob Resist Infect Control. 2012;1: 31. DOI: 10.1186/2047-2994-1-31
- 6. Suntharam N, Lankford MG, Trick WE, et al. Risk factors for acquisition of vancomycin-resistant enterococci among hematology-oncology patients. Diagn Microbiol Infect Dis. 2002;43: 183–188. DOI: 10.1016/s0732-8893(02)00392-9
- 7. Drees M, Snydman DR, Schmid CH, et al. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis. 2008;46: 678–685. DOI: 10.1086/527394
- 8. Doganci M, Izdes S, Cirik MO. The Evaluation of Risk Factors for Vancomycin-Resistant Enterococcus Colonization and Infection Among Mixed Adult Intensive Care Unit Patients. Cureus. 2023;15: e33210. DOI: 10.7759/cureus.33210
- 9. Hughes A, Sullivan SG, Marshall C. Factors associated with vanA VRE acquisition in Cardiothoracic Surgery patients during an acute outbreak. Infect Dis Health. 2021;26: 258–264. DOI: 10.1016/j.idh.2021.05.003
- 10. Yoon YK, Lee MJ, Ju Y, et al. Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case-control study. Ann Clin Microbiol Antimicrob. 2019;18: 28. DOI: 10.1186/s12941-019-0327-8
- 11. Huckabee CM, Huskins WC, Murray PR.Predicting Clearance of Colonization with Vancomycin-Resistant Enterococci and Methicillin-Resistant Staphylococcus aureus by Use of Weekly Surveillance Cultures. J Clin Microbiol 2009;47:1229–1230 DOI: 10.1128/jcm.02424-08
- 12. Ziakas PD, Thapa R, Rice LB, et al. Trends and Significance of VRE Colonization in the ICU: A Meta-Analysis of Published Studies. PLoS ONE 2013;8:e75658. DOI: 10.1371/journal.pone.0075658
- 13. Endtz HP, Van Den Braak N, Van Belkum A, et al. Fecal carriage of vancomycin-resistant enterococci in hospitalized patients and those living in the community in The Netherlands. Journal of Clinical Microbiology 1997;35:3026–31. DOI: 10.1128/jcm.35.12.3026-3031.1997
- 14. Remschmidt C, Behnke M, Kola A, et al. The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study. Antimicrobial Resistance & Infection Control 2017;6. DOI: 10.1186/s13756-017-0253-5
- 15. Choi HE, Lee JH, Sim Y-J, et al. Predictors of prolonged vancomycin-resistant enterococci colonization in acute stroke patients admitted to an intensive care unit. Medicine 2021;100:e26913. DOI: 10.1097/MD.0000000000026913
- 16. Olivier CN, Blake RK, Steed LL, et al. Risk of vancomycin-resistant Enterococcus (VRE) bloodstream infection among patients colonized with VRE. Infect Control Hosp Epidemiol. 2008;29:404-9. DOI: 10.1086/587647.
- 17. Topcuoglu S, Gursoy T, Ovalı F, Serce O, Karatekin G. A new risk factor for neonatal vancomycin-resistant Enterococcus colonisation: bacterial probiotics. The Journal of Maternal-Fetal & Neonatal Medicine. 2014;28:1491–1494. DOI: 10.3109/14767058.2014.958462
- 18. Htun HL, Hon P-Y, Tan R, et al. Synergistic effects of length of stay and prior MDRO carriage on the colonization and co-colonization of methicillin-resistant , vancomycin-resistant , and carbapenemase-producing Enterobacterales across healthcare settings. Infect Control Hosp Epidemiol. 2023;44: 31–39. DOI: 10.1017/ice.2022.57
- 19. Yılmaz NO, Agus N, Yurtsever S, Ozer E, Afacan G, Oner O. (2009). Prevalence and risk factors associated with vancomycin-resistant enterococci colonization. Revista De Ciências Médicas E Biológicas. 2009;8(3):283–291.
- 20. Pugliese G, Favero MS. Intra-abdominal VRE infections the new threat. Infect Control Hosp Epidemiol. 2001;22: 346–346. DOI: 10.1097/00004836-200104000-00011
- 21. Rasilainen SK, Juhani MP, Kalevi LA. Microbial colonization of open abdomen in critically ill surgical patients. World J Emerg Surg. 2015;10: 25. DOI: 10.1186/s13017-015-0018-5
- 22. Ajao AO, Harris AD, Roghmann M-C, et al. Systematic review of measurement and adjustment for colonization pressure in studies of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile acquisition. Infect Control Hosp Epidemiol. 2011;32: 481–489. DOI: 10.1086/659403
- 23. Pan S-C, Wang J-T, Chen Y-C,et al. Incidence of and risk factors for infection or colonization of vancomycin-resistant enterococci in patients in the intensive care unit. PLoS One. 2012;7: e47297. DOI: 10.1371/journal.pone.0047297
- 24. Janjusevic A, Cirkovic I, Minic R, et al. Predictors of Vancomycin-Resistant spp. Intestinal Carriage among High-Risk Patients in University Hospitals in Serbia. Antibiotics (Basel). 2022;11. DOI: 10.3390/antibiotics11091228
- 25. Ford CD, Lopansri BK, Haydoura S, et al. Frequency, risk factors, and outcomes of vancomycin-resistant Enterococcus colonization and infection in patients with newly diagnosed acute leukemia: different patterns in patients with acute myelogenous and acute lymphoblastic leukemia. Infect Control Hosp Epidemiol. 2015;36: 47–53. DOI:10.1017/ice.2014.3
Risk Factors for Colonization of Vancomycin-Resistant Enterococci in Patients in the Intensive Care Unit: A single-center Retrospective Study
Abstract
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.
References
- 1. Cairns KA, Udy AA, Peel TN, et al. Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections. Clin Microbiol Rev. 2023;36: e0005922. DOI: 10.1128/cmr.00059-22
- 2. Eichel VM, Last K, Brühwasser C, et al. Epidemiology and outcomes of vancomycin-resistant enterococcus infections: a systematic review and meta-analysis. J Hosp Infect. 2023;141: 119–128. DOI: 10.1016/j.jhin.2023.09.008
- 3. Tacconelli E, Cataldo MA. Vancomycin-resistant enterococci (VRE): transmission and control. Int J Antimicrob Agents. 2008;31: 99–106. DOI: 10.1016/j.ijantimicag.2007.08.026
- 4. Elizaga ML, Weinstein RA, Hayden MK. Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci. Clin Infect Dis. 2002;34: 441–446. DOI: 10.1086/338461
- 5. Karki S, Houston L, Land G, et al. Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study. Antimicrob Resist Infect Control. 2012;1: 31. DOI: 10.1186/2047-2994-1-31
- 6. Suntharam N, Lankford MG, Trick WE, et al. Risk factors for acquisition of vancomycin-resistant enterococci among hematology-oncology patients. Diagn Microbiol Infect Dis. 2002;43: 183–188. DOI: 10.1016/s0732-8893(02)00392-9
- 7. Drees M, Snydman DR, Schmid CH, et al. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis. 2008;46: 678–685. DOI: 10.1086/527394
- 8. Doganci M, Izdes S, Cirik MO. The Evaluation of Risk Factors for Vancomycin-Resistant Enterococcus Colonization and Infection Among Mixed Adult Intensive Care Unit Patients. Cureus. 2023;15: e33210. DOI: 10.7759/cureus.33210
- 9. Hughes A, Sullivan SG, Marshall C. Factors associated with vanA VRE acquisition in Cardiothoracic Surgery patients during an acute outbreak. Infect Dis Health. 2021;26: 258–264. DOI: 10.1016/j.idh.2021.05.003
- 10. Yoon YK, Lee MJ, Ju Y, et al. Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case-control study. Ann Clin Microbiol Antimicrob. 2019;18: 28. DOI: 10.1186/s12941-019-0327-8
- 11. Huckabee CM, Huskins WC, Murray PR.Predicting Clearance of Colonization with Vancomycin-Resistant Enterococci and Methicillin-Resistant Staphylococcus aureus by Use of Weekly Surveillance Cultures. J Clin Microbiol 2009;47:1229–1230 DOI: 10.1128/jcm.02424-08
- 12. Ziakas PD, Thapa R, Rice LB, et al. Trends and Significance of VRE Colonization in the ICU: A Meta-Analysis of Published Studies. PLoS ONE 2013;8:e75658. DOI: 10.1371/journal.pone.0075658
- 13. Endtz HP, Van Den Braak N, Van Belkum A, et al. Fecal carriage of vancomycin-resistant enterococci in hospitalized patients and those living in the community in The Netherlands. Journal of Clinical Microbiology 1997;35:3026–31. DOI: 10.1128/jcm.35.12.3026-3031.1997
- 14. Remschmidt C, Behnke M, Kola A, et al. The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study. Antimicrobial Resistance & Infection Control 2017;6. DOI: 10.1186/s13756-017-0253-5
- 15. Choi HE, Lee JH, Sim Y-J, et al. Predictors of prolonged vancomycin-resistant enterococci colonization in acute stroke patients admitted to an intensive care unit. Medicine 2021;100:e26913. DOI: 10.1097/MD.0000000000026913
- 16. Olivier CN, Blake RK, Steed LL, et al. Risk of vancomycin-resistant Enterococcus (VRE) bloodstream infection among patients colonized with VRE. Infect Control Hosp Epidemiol. 2008;29:404-9. DOI: 10.1086/587647.
- 17. Topcuoglu S, Gursoy T, Ovalı F, Serce O, Karatekin G. A new risk factor for neonatal vancomycin-resistant Enterococcus colonisation: bacterial probiotics. The Journal of Maternal-Fetal & Neonatal Medicine. 2014;28:1491–1494. DOI: 10.3109/14767058.2014.958462
- 18. Htun HL, Hon P-Y, Tan R, et al. Synergistic effects of length of stay and prior MDRO carriage on the colonization and co-colonization of methicillin-resistant , vancomycin-resistant , and carbapenemase-producing Enterobacterales across healthcare settings. Infect Control Hosp Epidemiol. 2023;44: 31–39. DOI: 10.1017/ice.2022.57
- 19. Yılmaz NO, Agus N, Yurtsever S, Ozer E, Afacan G, Oner O. (2009). Prevalence and risk factors associated with vancomycin-resistant enterococci colonization. Revista De Ciências Médicas E Biológicas. 2009;8(3):283–291.
- 20. Pugliese G, Favero MS. Intra-abdominal VRE infections the new threat. Infect Control Hosp Epidemiol. 2001;22: 346–346. DOI: 10.1097/00004836-200104000-00011
- 21. Rasilainen SK, Juhani MP, Kalevi LA. Microbial colonization of open abdomen in critically ill surgical patients. World J Emerg Surg. 2015;10: 25. DOI: 10.1186/s13017-015-0018-5
- 22. Ajao AO, Harris AD, Roghmann M-C, et al. Systematic review of measurement and adjustment for colonization pressure in studies of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile acquisition. Infect Control Hosp Epidemiol. 2011;32: 481–489. DOI: 10.1086/659403
- 23. Pan S-C, Wang J-T, Chen Y-C,et al. Incidence of and risk factors for infection or colonization of vancomycin-resistant enterococci in patients in the intensive care unit. PLoS One. 2012;7: e47297. DOI: 10.1371/journal.pone.0047297
- 24. Janjusevic A, Cirkovic I, Minic R, et al. Predictors of Vancomycin-Resistant spp. Intestinal Carriage among High-Risk Patients in University Hospitals in Serbia. Antibiotics (Basel). 2022;11. DOI: 10.3390/antibiotics11091228
- 25. Ford CD, Lopansri BK, Haydoura S, et al. Frequency, risk factors, and outcomes of vancomycin-resistant Enterococcus colonization and infection in patients with newly diagnosed acute leukemia: different patterns in patients with acute myelogenous and acute lymphoblastic leukemia. Infect Control Hosp Epidemiol. 2015;36: 47–53. DOI:10.1017/ice.2014.3
There are 25 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Infectious Diseases |
| Journal Section | Clinical Research |
| Authors | |
| Early Pub Date | December 10, 2024 |
| Publication Date | |
| Submission Date | June 3, 2024 |
| Acceptance Date | September 26, 2024 |
| Published in Issue | Year 2025Issue: Kabul Edilen Makaleler |