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Vancomycin-resistant Enterococcus (VRE) has been established as a significant healthcare-associated problem. Karki, et al. (2012) measured the point prevalence and identified risk factors associated with vanB VRE colonization in a tertiary-care hospital in Melbourne, Australia where VRE has been endemic for 15 years.
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A hospital-wide point prevalence survey was conducted on Oct. 13, 2008 with colonization detected using rectal swab culture. Patients' demographic and medical information was collected through a review of medical records. Factors associated with VRE colonization in univariate analysis were included in multivariate logistic regression model to adjust for confounding.
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The prevalence of VRE colonization on the day of screening was 17.5 percent. VRE was detected from patients in each ward with the prevalence ranging from 3 percent to 29 percent. Univariate analysis showed the use of any antibiotic, meropenem, ciprofloxacin, diarrhea and longer length of hospital stay were associated with increased risk of VRE colonization (p<0.05). However, age, sex, proximity to VRE positive cases, use of other antibiotics including cephalosporins, vancomycin were not associated with increased risk (P>0.05). Multivariate analysis showed the exposure to meropenem (p=0.004), age (>=65 years) (p=0.036) and length of stay >=7 days (p<0.001) as independent predictors of VRE colonization.
The researchers say their study suggests that exposure to antibiotics may have been more important than recent cross transmission for a high prevalence of vanB VRE colonisation at their hospital. Their research was published in Antimicrobial Resistance and Infection Control.
Reference: Karki S, et al. Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study. Antimicrobial Resistance and Infection Control 2012, 1:31 doi:10.1186/2047-2994-1-31