Factors associated with Infection or Colonization of Vancomycin-Resistant Enterococci (VRE) among Hospitalized Patients in Chonburi Hospital

Abstract

This matched case-control study aims were to describe the epidemiology of vancomycin-resistant enterococci (VRE), including both infections and colonization, and to identify factors associated with infection or colonization of VRE among hospitalized patients. The study was conducted at Chonburi Hospital between January 1, 2011 and December 31, 2018. The cases were 75 patients colonized or infected with VRE, and the controls were 150 patients with vancomycin-sensitive enterococci isolates. Both groups were matched by sex, age ±5 years, and same type of specimens in the same month. Data were collected retrospectively from the hospital’s electronic medical record database and culture test results. Conditional logistic regression was used to identify risk factors for VRE infection or colonization. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. A p-value of less than 0.05 (<0.05) was considered to indicate statistical significance.  

The results revealed that patients with indwelling medical devices (e.g. endotracheal tube, NG tube) were found in both groups. Patients in both case and control groups had been prescribed antibiotics within one month (94.7% and 74%, respectively). E. faecium isolates were more resistant to vancomycin than E. faecalis (96% and 4% respectively). Factors associated with VRE infection or colonization included previous administration of vancomycin (OR _adj = 14.36; 95% CI, 3.81-54.03), cephalosporins (OR _adj = 3.49; 95% CI, 1.49-8.14) and colistin (OR _adj = 7.84; 95% CI, 2.23-27.69) within one month during the period of hospitalization. The findings highlight the need for promoting the rational use of antibiotics and strengthening of infection control procedures and practices to prevent the spread of VRE in the hospital.