Jennie Johnstone1, Cynthia Chen2, Laura Rosella3, Kwaku Adomako4, Michelle E Policarpio4, Freda Lam4, Chatura Prematunge4, Gary Garber5. 1. Public Health Ontario, Toronto, ON, Canada; St. Joseph's Health Center, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Electronic address: jennie.johnstone@oahpp.ca. 2. Public Health Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. 3. Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. 4. Public Health Ontario, Toronto, ON, Canada. 5. Public Health Ontario, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Abstract
BACKGROUND: Data are limited on risk factors for vancomycin-resistant Enterococcus (VRE) bacteremia. METHODS: All patients with a confirmed VRE bacteremia in Ontario, Canada, between January 2009 and December 2013 were linked to provincial healthcare administrative data sources and frequency matched to 3 controls based on age, sex, and aggregated diagnosis group. Associations between predictors and VRE bacteremia were estimated by generalized estimating equations and summarized using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). RESULTS: In total, 217 cases and 651 controls were examined. In adjusted analyses, patient-level predictors included bone marrow transplant (OR 106.99 [95% CI 12.19-939.26]); solid organ transplant (OR 17.17 [95% CI 4.95-59.54]); any cancer (OR 8.64 [95% CI 3.88-19.21]); intensive care unit (ICU) admission (OR 6.81 [95% CI 3.53-13.13]); heart disease (OR 5.27 [95% CI 2.00-13.90]); and longer length of stay (OR 1.07 per day [95% CI 1.06-1.09]). Hospital-level predictors included hospital size (per increase in 100 beds (OR 1.26 [95% CI 1.07-1.48]) and teaching hospitals (OR 3.87 [95% CI 1.85-8.08]). CONCLUSIONS: Patients with a bone marrow transplant, solid organ transplant, cancer, or who are admitted to the ICU are at highest risk of VRE bacteremia, particularly at large hospitals and teaching hospitals. Crown
BACKGROUND: Data are limited on risk factors for vancomycin-resistant Enterococcus (VRE) bacteremia. METHODS: All patients with a confirmed VRE bacteremia in Ontario, Canada, between January 2009 and December 2013 were linked to provincial healthcare administrative data sources and frequency matched to 3 controls based on age, sex, and aggregated diagnosis group. Associations between predictors and VRE bacteremia were estimated by generalized estimating equations and summarized using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). RESULTS: In total, 217 cases and 651 controls were examined. In adjusted analyses, patient-level predictors included bone marrow transplant (OR 106.99 [95% CI 12.19-939.26]); solid organ transplant (OR 17.17 [95% CI 4.95-59.54]); any cancer (OR 8.64 [95% CI 3.88-19.21]); intensive care unit (ICU) admission (OR 6.81 [95% CI 3.53-13.13]); heart disease (OR 5.27 [95% CI 2.00-13.90]); and longer length of stay (OR 1.07 per day [95% CI 1.06-1.09]). Hospital-level predictors included hospital size (per increase in 100 beds (OR 1.26 [95% CI 1.07-1.48]) and teaching hospitals (OR 3.87 [95% CI 1.85-8.08]). CONCLUSIONS:Patients with a bone marrow transplant, solid organ transplant, cancer, or who are admitted to the ICU are at highest risk of VRE bacteremia, particularly at large hospitals and teaching hospitals. Crown
Authors: Andrea C Büchler; Silvio Ragozzino; Melanie Wicki; Violeta Spaniol; Sammy Jäger; Helena M B Seth-Smith; Daniel Goldenberger; Vladimira Hinic; Adrian Egli; Reno Frei; Andreas F Widmer Journal: Antimicrob Resist Infect Control Date: 2022-04-13 Impact factor: 4.887