Predictors and outcomes of linezolid-resistant vancomycin-resistant Enterococcus: A case-case-control study

Abstract We estimated the impact of vancomycin-resistant Enterococcus (VRE) infection on the outcomes of patients with leukemia in a case-control study. Compared with their matched controls (n = 45), cases (n = 23) had 22% greater total charges and shorter survival (P= .04). These findings substantiate the need for aggressive interventions to prevent VRE transmission.

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Risk Factors for Vancomycin-resistant Enterococcus faecalis bacteremia: A Case-Case-Control Study

American Journal of Infection Control ◽

10.1016/j.ajic.2012.04.052 ◽

2012 ◽

Vol 40 (5) ◽

pp. e31-e32

Author(s):

Kayoko Hayakawa ◽

Dror Marchaim ◽

Mohan B. Palla ◽

Uma Mahesh ◽

...

Keyword(s):

Risk Factors ◽

Enterococcus Faecalis ◽

Case Control Study ◽

Case Control ◽

Vancomycin Resistant Enterococcus ◽

Vancomycin Resistant ◽

Control Study

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Descriptive Epidemiology and Case-Control Study of Patients Colonized With Vancomycin-Resistant Enterococcus and Methicillin-ResistantStaphylococcus aureus

Infection Control and Hospital Epidemiology ◽

10.1086/507278 ◽

2006 ◽

Vol 27 (9) ◽

pp. 913-919 ◽

Cited By ~ 8

Author(s):

Bryndis Sigurdardottir ◽

Jeffery Vande Berg ◽

Jianfang Hu ◽

Josiah Alamu ◽

Louise-Anne McNutt ◽

...

Keyword(s):

Risk Factors ◽

Renal Insufficiency ◽

Active Surveillance ◽

Case Control Study ◽

Tertiary Care ◽

Case Control ◽

Vancomycin Resistant Enterococcus ◽

Methicillin Resistant ◽

Vancomycin Resistant ◽

Control Study

Background.Patients colonized or infected with vancomycin-resistant enterococcus and methicillin-resistantStaphylococcus aureusmay be at risk of acquiring vancomycin-resistantS. aureusif the vanA gene is transferred from vancomycin-resistant enterococcus to methicillin-resistantS. aureus..Objective.Our goal was to identify risk factors for cocolonization or coinfection (CC/CI) with vancomycin-resistant enterococcus and methicillin-resistantS. aureus.Design.We conducted a descriptive, epidemiologic study of all patients with CC/CI identified from January 1998 to May 2003 and a nested case-control study of a cohort of patients hospitalized in the burn and wound unit.Setting.We conducted our study in a 813-bed tertiary care university teaching hospital.Population.The study population consisted of patients found to have CC/CI during the study period.Methods.Descriptive epidemiologic data were collected from hospital records of all patients identified as having CC/CI. A subset of patients hospitalized in the burn and wound unit were included in a case-control study.Results.CC/CI was detected in 71% of the patients during a single hospital stay. The burn and wound unit, which does active surveillance for both organisms, and the general medicine unit, which does not do active surveillance for either organism, cared for more than one-half of these patients. Among patients being cared for in the burn and wound unit, having exposure to 2 or more invasive devices (central venous catheters, indwelling urinary catheters, and enteral feeding tubes) and renal insufficiency were independent risk factors for CC/CI.Conclusions.Patients with CC/CI are the population at greatest risk for vancomycin-resistantS. aureuscolonization or infection. The number of invasive devices to which patients are exposed and, thus, possibly the patients' underlying severity of illness, as well as renal insufficiency, appear to be risk factors for CC/CI.

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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

Annals of Clinical Microbiology and Antimicrobials ◽

10.1186/s12941-019-0327-8 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Young Kyung Yoon ◽

Min Jung Lee ◽

Yongguk Ju ◽

Sung Eun Lee ◽

Kyung Sook Yang ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Intensive Care ◽

Clinical Outcomes ◽

Intensive Care Units ◽

Case Control Study ◽

Case Control ◽

Methicillin Resistant ◽

Vancomycin Resistant ◽

Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

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Colonization with antibiotic-susceptible strains protects against methicillin-resistant Staphylococcus aureus but not vancomycin-resistant enterococci acquisition: a nested case-control study

Critical Care ◽

10.1186/cc10445 ◽

2011 ◽

Vol 15 (5) ◽

pp. R210 ◽

Cited By ~ 18

Author(s):

Susan S Huang ◽

Rupak Datta ◽

Sheryl Rifas-Shiman ◽

Ken Kleinman ◽

Hilary Placzek ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Case Control Study ◽

Case Control ◽

Methicillin Resistant ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Nested Case Control ◽

Control Study

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Outbreak of Vancomycin-Resistant Enterococci in a Burn Unit

Infection Control and Hospital Epidemiology ◽

10.1086/501806 ◽

2000 ◽

Vol 21 (9) ◽

pp. 575-582 ◽

Cited By ~ 103

Author(s):

Pamela S. Falk ◽

Janice Winnike ◽

Carta Woodmansee ◽

M. Desai ◽

C. Glen Mayhall

Keyword(s):

Case Control Study ◽

Index Case ◽

Case Control ◽

Gi Tract ◽

Environmental Isolates ◽

Pfge Typing ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Environmental Decontamination ◽

Control Study

AbstractObjective:To investigate and control an outbreak of colonization and infection caused by vancomycin-resistant enterococci (VRE) in a burn intensive care unit (BICU).Design:Epidemiological investigation, including multiple point-prevalence culture surveys of patients and environment, cultures from hands of healthcare workers (HCWs), pulsed-field gel electrophoresis (PFGE) typing of patient and environmental isolates, case-control study, and institution and monitoring of control measures.Setting:BICU in an 800-bed university medical center in Galveston, Texas.Results:Between June 6, 1996, and July 14, 1997, 21 patients were colonized by VRE, and 4 of these patients developed bacteremia. Of 2,844 environmental cultures, 338 (11.9%) were positive, but all hand cultures from HCWs were negative. PFGE typing indicated that the outbreak was clonal, with VRE isolates from patients differing by ≤4 bands from the index case. Thirteen of 14 environmental isolates varied by ≤4 bands from the pattern of the index case. A case-control study analyzed by exact logistic regression identified diarrhea (odds ratio [OR], 43.9; 95% confidence interval [CI95], 5.5-infinity;P=.0001) and administration of an antacid (OR, 24.2; CI95,2.9-infinity;P=.002) as independent risk factors for acquisition of VRE. During a 5-week period in October and November 1996, all patient and 317 environmental cultures were negative for VRE. The outbreak recurred from a contaminated electrocardiogram lead that had not been identified during the prior 5 weeks. VRE were finally eradicated from the BICU in July 1997, using barrier isolation and a very aggressive environmental decontamination program.Conclusions:A VRE outbreak in a BICU over 13 months was caused by a single clone. After apparent eradication of VRE from a BICU, recrudescence of the outbreak occurred, evidently from a small inapparent source of environmental contamination. Changes in gastrointestinal (GI) tract function (motility) and administration of medications, other than antibiotics, that have an effect on the GI tract may increase the risk of GI tract colonization by VRE in burn patients. Application of barrier isolation and an aggressive environmental decontamination program can eradicate VRE from a burn population.

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Epidemiology of Vancomycin-Resistant Enterococci with Reduced Susceptibility to Daptomycin

Infection Control and Hospital Epidemiology ◽

10.1086/668438 ◽

2012 ◽

Vol 33 (12) ◽

pp. 1250-1254 ◽

Cited By ~ 20

Author(s):

Theresa Judge ◽

Jason M. Pogue ◽

Dror Marchaim ◽

Kevin Ho ◽

Srinivasa Kamatam ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Prior Exposure ◽

Comorbid Conditions ◽

Retrospective Case ◽

Vancomycin Resistant Enterococci ◽

Independent Risk Factors ◽

Vancomycin Resistant ◽

Control Study

A retrospective case–case control study was conducted, including 60 cases with daptomycin-nonsusceptible vancomycin-resistant enterococci (DNS-VRE) matched to cases with daptomycin-susceptible VRE and to uninfected controls (1:1:3 ratio). Immunosuppression, presence of comorbid conditions, and prior exposure to antimicrobials were independent predictors of DNS-VRE, although prior daptomycin exposure occurred rarely. In summary, a case–case control study identified independent risk factors for the isolation of DNS-VRE: immunosuppression, multiple comorbid conditions, and prior exposures to cephalosporines and metronidazole.

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Predictors for vancomycin resistant Enterococcus faecium transforming from colonization to infection: a case control study

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0647-7 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Pao-Yu Chen ◽

Yu-Chung Chuang ◽

Jann-Tay Wang ◽

Wang-Huei Sheng ◽

Yee-Chun Chen ◽

...

Keyword(s):

Risk Factors ◽

Enterococcus Faecium ◽

Case Control Study ◽

Case Control ◽

Control Measures ◽

Fourth Generation ◽

Surveillance Culture ◽

Icu Admission ◽

Vancomycin Resistant ◽

Control Study

Abstract Background Little is known about risk factors for subsequent infections among vancomycin resistant Enterococcus faecium (VREfm) colonizers, especially characterized by concordant pulsotypes (CP) of paired colonization and infection-related isolates. Methods This case-control study was conducted at a teaching hospital between 2011 and 2014. Targeted patients received active surveillance culture for VREfm by anal swabs at admission. Cases were those who developed VREfm infection within 180 days after colonization of VREfm. Controls were those colonized with VREfm without subsequent VREfm infection. CP were defined by similarities ≥86.7% using pulsed-field gel electrophoresis between paired colonization and infection-related isolates. Results Ninety-seven cases and 194 controls were enrolled. By conditional multivariable logistic regression analysis, the risk factors for subsequent infection among VREfm colonizers were intensive care unit (ICU) admission (adjusted odds ratio [aOR], 9.32; 95% CI, 3.61–24.02), receipt of central venous catheters (CVC) (aOR, 3.38; 95% CI, 1.30–8.82), and utilization of third- and fourth-generation cephalosporins (aOR, 4.06; 95% CI, 1.79–9.20, and aOR, 5.32; 95% CI, 1.85– 10.29, respectively) (all P ≤ 0.01). Fifty-six (57.7%) of case patients belonged to the CP group, which were associated with ICU admission (aOR, 3.74; 95% CI, 1.38–10.13), and infection developing within 30 days after colonization (aOR, 3.34; 95% CI, 1.25–8.91). Conclusions Among VREfm colonizers, being admitted to ICU and receiving CVC or broad spectrum cephalosporins, were the risk factors for subsequent infections. These findings highlight the importance of conducting more strict infection control measures on specific groups of VREfm colonizers.

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