title: Risk Factors and Outcomes of Vancomycin-ResistantEnterococcusColonization in Patients on Peritoneal Dialysis: A Single-Center Study in Hong Kong.
abstract: BACKGROUND
  Vancomycin-resistantEnterococcus(VRE) colonization is common among patients with chronic kidney disease. However, data concerning VRE colonization among patients receiving peritoneal dialysis (PD) is lacking. The aim of this study is to evaluate the risk factors and various clinical outcomes for VRE colonization among PD patients.
  
  
  METHODS
  This is a retrospective cohort study of 166 PD patients who were hospitalized between 1 August 2013 and 31 July 2014. They were screened for VRE colonization status during a major VRE outbreak in Hong Kong in 2013 and were then categorized into 2 groups: VRE-positive and VRE-negative. The primary outcome was all-cause mortality while the secondary outcomes included VRE infection, PD-related peritonitis, and length of hospitalization.
  
  
  RESULTS
  Twenty-eight patients (16.9%) belonged to the VRE-positive group. Multivariate analysis showed that previous contact with VRE-positive patients (odds ratio [OR]: 417.86; 95% confidence interval [CI]: 17.21 - 10,147.26,p< 0.01), vancomycin use in previous 3 months (OR: 130.32; 95% CI: 5.35 - 3,176.30,p< 0.01), and old age (OR: 1.13; 95% CI: 1.02 - 1.24,p= 0.02) were the independent risk factors for VRE colonization. Patients in the VRE-positive group had significantly longer length of hospitalization, but there was no significant difference in all-cause mortality and peritonitis-free survival.
  
  
  CONCLUSIONS
  Vancomycin-resistantEnterococcuscolonization is important among hospitalized PD patients. Cautious use of antibiotics and infection control measures are necessary to prevent VRE spreading, especially in high-risk patients.
authors.affiliation: Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Ching-Shan
authors.initials: CS
authors.lastname: Yeung
authors.affiliation: Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR simoncycheung@gmail.com.
authors.forename: Chi-Yuen
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Yiu-Han
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Wai-Leung
authors.initials: WL
authors.lastname: Chak
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology*; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020713:Vancomycin Resistance; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*
keywords: Peritoneal dialysis; vancomycin-resistant Enterococcus