Abdurrahman Kaya1, Sibel Yıldız Kaya2, Ilker Inanç Balkan3, Osman Faruk Bayramlar4, Bilgül Mete3, Neşe Saltoglu3, Gökhan Aygün5, Ömer Fehmi Tabak3. 1. Department of Infectious Disease, Istanbul Training and Research Hospital, Istanbul, Turkey. dr.abdkaya@hotmail.com. 2. Department of Infectious Disease, Sungurlu State Hospital, Çorum, Turkey. 3. Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey. 4. Istanbul Medicine Faculty, Public Health Department, Istanbul University, Istanbul, Turkey. 5. Department of Medical Microbiolog, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey.
Abstract
AIMS: We aimed to determine the proportion of vancomycin-resistant enterococci (VRE) colonized patients among all inpatients who later developed VRE bacteremia during hospital stay and to identify the risk factors for VRE bacteremia at a tertiary hospital. MATERIAL AND METHODS: Patients with positive rectal screening or any clinically significant positive culture results for VRE were included in 1‑year follow-up. Colonization with VRE was defined as a positive culture (rectal, stool, urinary) for VRE without infection and VRE bacteremia was defined as positive blood culture if the signs and symptoms were compatible with infection. To determine the risk factors for VRE bacteremia among VRE colonized patients, a retrospective case control study was performed. The two groups were compared in terms of variables previously defined as risk factors in the literature. RESULTS: Of 947 positive samples, 17 VRE bacteremia were included in the analysis. Cephalosporin use for more than 3 days within 3 months was a significant risk factor for bacteremia (p = 0.008). Prior use of carbapenems was found to be statistically significant for bacteremia (p = 0.007). In multivariate analyses the use of carbapenems and cephalosporins was an independent risk factor for developing bacteremia among VRE colonizers (odds ratio, OR, 6.67; 95% confidence interval, CI, 1.30-34; p = 0.022 and OR 4.32, 95% CI 1.23-15; p = 0.022, respectively). CONCLUSION: A VRE colonization in patients receiving broad-spectrum beta-lactam antibiotics including carbapenems and cephalosporins may result in bacteremia. It is possible to keep mortality at very low levels in VRE bacteremia with effective infection control measures, rapid infectious diseases consultation and rational antimicrobial treatment based on current epidemiological data.
AIMS: We aimed to determine the proportion of vancomycin-resistant enterococci (VRE) colonized patients among all inpatients who later developed VRE bacteremia during hospital stay and to identify the risk factors for VRE bacteremia at a tertiary hospital. MATERIAL AND METHODS:Patients with positive rectal screening or any clinically significant positive culture results for VRE were included in 1‑year follow-up. Colonization with VRE was defined as a positive culture (rectal, stool, urinary) for VRE without infection and VRE bacteremia was defined as positive blood culture if the signs and symptoms were compatible with infection. To determine the risk factors for VRE bacteremia among VRE colonized patients, a retrospective case control study was performed. The two groups were compared in terms of variables previously defined as risk factors in the literature. RESULTS: Of 947 positive samples, 17 VRE bacteremia were included in the analysis. Cephalosporin use for more than 3 days within 3 months was a significant risk factor for bacteremia (p = 0.008). Prior use of carbapenems was found to be statistically significant for bacteremia (p = 0.007). In multivariate analyses the use of carbapenems and cephalosporins was an independent risk factor for developing bacteremia among VRE colonizers (odds ratio, OR, 6.67; 95% confidence interval, CI, 1.30-34; p = 0.022 and OR 4.32, 95% CI 1.23-15; p = 0.022, respectively). CONCLUSION: A VRE colonization in patients receiving broad-spectrum beta-lactam antibiotics including carbapenems and cephalosporins may result in bacteremia. It is possible to keep mortality at very low levels in VRE bacteremia with effective infection control measures, rapid infectious diseases consultation and rational antimicrobial treatment based on current epidemiological data.
Authors: Aslınur Özkaya-Parlakay; Ali Bülent Cengiz; Mehmet Ceyhan; Arzu Bağdat; Çağrı Barın-Kurtoğlu; Venhar Gürbüz; Ahmet Emre Aycan; Ateş Kara Journal: Turk J Pediatr Date: 2014 Nov-Dec Impact factor: 0.552
Authors: J M van Niekerk; M Lokate; L M A Braakman-Jansen; J E W C van Gemert-Pijnen; A Stein Journal: BMC Infect Dis Date: 2022-01-20 Impact factor: 3.090