Vancomycin-resistant Enterococcus faecium: admission prevalence, sequence types and risk factors-a cross-sectional study in seven German university hospitals from 2014 to 2018.
Admission prevalence
Colonization
Risk factors
ST117
VREfm
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
01
09
2022
revised:
11
11
2022
accepted:
27
11
2022
medline:
4
4
2023
pubmed:
9
12
2022
entrez:
8
12
2022
Statut:
ppublish
Résumé
Assessment of vancomycin-resistant Enterococcus faecium (VREfm) prevalence upon hospital admission and analysis of risk factors for colonization. From 2014 to 2018, patients were recruited within 72 hours of admission to seven participating German university hospitals, screened for VREfm and questioned for potential risk factors (prior multidrug-resistant organism detection, current/prior antibiotic consumption, prior hospital, rehabilitation or long-term care facility stay, international travel, animal contact and proton pump inhibitor [PPI]/antacid therapy). Genotype analysis was done using cgMLST typing. Multivariable analysis was performed. In 5 years, 265 of 17,349 included patients were colonized with VREfm (a prevalence of 1.5%). Risk factors for VREfm colonization were age (adjusted OR [aOR], 1.02; 95% CI, 1.01-1.03), previous (aOR, 2.71; 95% CI, 1.87-3.92) or current (aOR, 2.91; 95% CI, 2.60-3.24) antibiotic treatment, prior multidrug-resistant organism detection (aOR, 2.83; 95% CI, 2.21-3.63), prior stay in a long-term care facility (aOR, 2.19; 95% CI, 1.62-2.97), prior stay in a hospital (aOR, 2.91; 95% CI, 2.05-4.13) and prior consumption of PPI/antacids (aOR, 1.29; 95% CI, 1.18-1.41). Overall, the VREfm admission prevalence increased by 33% each year and 2% each year of life. 250 of 265 isolates were genotyped and 141 (53.2%) of the VREfm were the emerging ST117. Multivariable analysis showed that ST117 and non-ST117 VREfm colonized patients differed with respect to admission year and prior multidrug-resistant organism detection. Age, healthcare contacts and antibiotic and PPI/antacid consumption increase the individual risk of VREfm colonization. The VREfm admission prevalence increase in Germany is mainly driven by the emergence of ST117.
Identifiants
pubmed: 36481293
pii: S1198-743X(22)00598-5
doi: 10.1016/j.cmi.2022.11.025
pii:
doi:
Substances chimiques
Vancomycin
6Q205EH1VU
Antacids
0
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
515-522Investigateurs
Barisch Bader
(B)
Lena Biehl
(L)
Michael Buhl
(M)
Ariane Dinkelacker
(A)
Moritz Fritzenwanker
(M)
Hanna Gölz
(H)
Catriona Hennelly
(C)
Susanne Herold
(S)
Azita Lengler
(A)
Dana Lenke
(D)
Gabriele Peyerl-Hoffmann
(G)
Luis Alberto Peña Diaz
(LA)
Georg Pilarski
(G)
Susanna Proske
(S)
Judith Schmiedel
(J)
Heike Spitznagel
(H)
Katrin Spohn
(K)
Norbert Thoma
(N)
Martina Vavra
(M)
Thorsten Wille
(T)
Maria J G T Vehreschild
(MJGT)
Informations de copyright
Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.