title: Predictors of vancomycin-resistant enterococcus (VRE) carriage in the first major VRE outbreak in Singapore.
abstract: BACKGROUND
  Until recently, vancomycin-resistant enterococcus (VRE) infection or colonisation was a rare occurrence in Singapore. The first major VRE outbreak involving a 1500-bed tertiary care institution in March 2005 presented major challenges in infection control and came at high costs. This study evaluates the predictors of VRE carriage based on patients' clinical and demographic profiles.
  
  
  METHODS
  Study patients were selected from the hospital inpatient census population during the VRE outbreak (aged 16 years or more). Clinical information from 84 cases and 377 controls were analysed.
  
  
  RESULTS
  Significant predictors of VRE carriage included: age>65 years Odds ratio (OR), 1.98; 95% CI (confidence interval), 1.14 to 3.43); female gender (OR, 2.15; 95% CI, 1.27 to 3.65); history of diabetes mellitus (OR, 1.94; 95% CI, 1.14 to 3.30), and staying in a crowded communal ward (OR, 2.75; 95% CI, 1.60 to 4.74). Each additional day of recent hospital stay also posed increased risk (OR, 1.03; 95% CI, 1.01 to 1.04).
  
  
  CONCLUSIONS
  Elderly diabetic females with prolonged hospitalisation in crowded communal wards formed the profile that significantly predicted VRE carriage in this major hospital-wide outbreak of VRE in Singapore. It is imperative that active VRE surveillance and appropriate infection control measures be maintained in these wards to prevent future VRE outbreaks.
authors.affiliation: Occupational Health and Epidemiology Unit, Singapore General Hospital, Singapore. dryangks@yahoo.com.sg
authors.forename: Kok-Soong
authors.initials: KS
authors.lastname: Yang
authors.forename: Yuke-Tien
authors.initials: YT
authors.lastname: Fong
authors.forename: Heow-Yong
authors.initials: HY
authors.lastname: Lee
authors.forename: Asok
authors.initials: A
authors.lastname: Kurup
authors.forename: Tse-Hsien
authors.initials: TH
authors.lastname: Koh
authors.forename: David
authors.initials: D
authors.lastname: Koh
authors.forename: Meng-Kin
authors.initials: MK
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D016983:Enterococcus / Q000187:drug effects*; D013293:Enterococcus faecalis / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000302:isolation & purification; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use; D020713:Vancomycin Resistance
chemical_list: D014640:Vancomycin