title: Risk-factors and predictors of mortality in patients colonised with vancomycin-resistant enterococci.
abstract: Vancomycin-resistant enterococci (VRE) have emerged as significant nosocomial pathogens. A hospital-wide prevalence study was performed to identify cases with VRE faecal colonisation. A case-control study using two randomly selected VRE-negative controls for each positive case was performed to assess risk-factors for VRE colonisation by univariate and multivariate analysis. VRE faecal colonisation was documented in 53 (14.3%) of 370 patients screened. Previous exposure to anti-anaerobic agents, as well as quinolones, was associated with VRE colonisation (p <0.05). The presence of an invasive device (OR 4.8, p 0.003) and the duration of any antimicrobial treatment before VRE isolation (OR 1.2, p <0.001) predicted VRE colonisation in multivariate models. The crude mortality rate for patients with VRE colonisation was 24.5%, but VRE colonisation was not an independent predictor of mortality in these patients. These results suggest that an active surveillance programme focusing on specific patient groups may help in the identification of VRE-colonised patients. Promptly implemented infection control strategies targeting these groups should help to combat the rising incidence of VRE.
authors.affiliation: 4th Department of Internal Medicine, University of Athens Medical School, Uniersity General Hospital Attikon, Athens, Greece. vissaria@gmail.com
authors.forename: V
authors.initials: V
authors.lastname: Sakka
authors.forename: S
authors.initials: S
authors.lastname: Tsiodras
authors.forename: L
authors.initials: L
authors.lastname: Galani
authors.forename: A
authors.initials: A
authors.lastname: Antoniadou
authors.forename: M
authors.initials: M
authors.lastname: Souli
authors.forename: I
authors.initials: I
authors.lastname: Galani
authors.forename: M
authors.initials: M
authors.lastname: Pantelaki
authors.forename: N
authors.initials: N
authors.lastname: Siafakas
authors.forename: L
authors.initials: L
authors.lastname: Zerva
authors.forename: H
authors.initials: H
authors.lastname: Giamarellou
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents