Abstract
Background: Vancomycin-resistant Enterococcus (VRE), as an important nosocomial pathogens, can be carried in gut for a long period and its colonization status associated with the subsequent infections. The aim of this study was to investigate the frequency of intestinal VRE colonization and identify the risk factors associated with VRE carriage in intensive care patients.Methods: We conducted a 4-week cross-sectional study at six hospitals in Beijing, China. Patients admitted to Intensive Care Units (ICUs) were screened for intestinal colonization of VRE every Tuesday morning. Rectal swabs were selectively cultured for VRE, then the identified strains were analyzed by PCR to detect the glycopeptide resistance gene and were characterized by MLST. Risk factors were recorded to assess their effect on VRE acquisition during ICUs stay.Results: Of 148 patients recruited, 46 (31.1%) were colonized with VRE, with the majority (n=42) being Enterococcus faecium. In total, 78.3% of the VRE were vanA positive and 15.2% vanM positive, while 6.5% undetected glycopeptide resistance gene. The predominant ST was ST78 (47.6%) followed by ST192 (14.3%), ST555 (9.5%), ST789 (9.5%), ST547 (4.8%), and ST922 (4.8%). Risk factors associated with VRE carriage were age of >65 years, a longer length of ICU stay, use of an endotracheal tube, and prior glycopeptides use.Conclusions: The overall incidence proportion of VRE colonization at ICUs was relatively high in Beijing, and clonal expansion and horizontal transmission of resistant genes were both found here. Routine screening is necessary to prevent the dissemination of VRE.
Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy
