Vancomycin-resistant enterococci, colonizing the intestinal tract of patients in a university hospital in Greece.
OBJECTIVE
Determine the prevalence of Vancomycin-resistant enterococci (VRE) colonizing the intestinal tract of hospitalized patients and define risk factors.


METHODS
A point prevalence survey of VRE fecal carriage was carried out among patients who stayed at a 600-bed teaching hospital for at least two days. Resistance to vancomycin was detected by the E-test method. Epidemiological data was recorded for all patients included in the study and was used for the risk factor analysis.


RESULTS
A total of 128 patients hospitalized for at least two days were enrolled in this investigation. Thirty-nine patients (30.5%) were colonized with vancomycin-resistant enterococci. Twenty-three of the 39 strains were identified as Enterococcus faecium, 13 were identified as Enterococcus gallinarum and three strains as Enterococcus casseliflavus. The risk factors that were significantly associated with VRE colonization included length of hospital stay (13.2 days vs. 8.6 days), age (60.7 years vs. 47.7 years) and the presence of underlying malignancies (28.2% vs. 11.2%). An association was found between VRE colonization and the use of antimicrobials with anaerobic activity, such as metronidazole, piperacillin/tazobactam and imipenem. The use of vancomycin was associated with VRE colonization in the intensive care unit.


CONCLUSIONS
VRE colonization must be monitored, and risk factors should be determined, because they are useful for screening hospitalized patients for VRE colonization in order to establish prevention and control measures.
Metallidis
Simeon
S
Infectious Diseases Division, First Internal Medicine Department, AHEPA University Hospital, Thessaloniki, Greece. metallidissimeon@yahoo.gr
Chatzidimitriou
Maria
M
Tsona
Afroditi
A
Bisiklis
Alexandros
A
Lazaraki
Georgia
G
Koumentaki
Eleni
E
Gikas
Ahilleas
A
Alexiou-Daniel
Stela
S
Nikolaidis
Pavlos
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D006115:Greece; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents