Enteric Carriage of Vancomycin-Resistant Enterococcus Faecium in Patients Tested for Clostridium Difficile

Infect Control Hosp Epidemiol. 1999 Oct;20(10):664-70. doi: 10.1086/501562.

Abstract

Objective: To identify independent risk factors for enteric carriage of vancomycin-resistant Enterococcus faecium (VREF) in hospitalized patients tested for Clostridium difficile toxin.

Design: Retrospective case-cohort study.

Setting: Tertiary-care teaching hospital.

Patients: Convenience sample of 215 adult inpatients who had stool tested for C difficile between January 29 and February 25, 1996.

Results: 41 (19%) of 215 patients had enteric carriage of VREE Five independent risk factors for enteric VREF were identified: history of prior C difficile (odds ratio [OR], 15.21; 95% confidence interval [CI95], 3.30-70.10; P < .001), parenteral treatment with vancomycin for > or = 5 days (OR, 4.06; CI95, 1.54-10.73; P = .005), treatment with antimicrobials effective against gram-negative organisms (OR, 3.44; CI95, 1.20-9.87; P = .021), admission from another institution (OR, 2.95; CI95, 1.21-7.18; P =.017), and age > 60 years (OR 2.57; CI95, 1.13-5.82; P = .024). These risk factors for enteric VREF were independent of the patient's current C difficile status.

Conclusions: Antimicrobial exposures are the most important modifiable independent risk factors for enteric carriage of VREF in hospitalized patients tested for C difficile.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Carrier State / epidemiology
  • Carrier State / microbiology*
  • Case-Control Studies
  • Clostridium difficile / isolation & purification
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Disease Reservoirs / statistics & numerical data
  • Enterococcus faecium / isolation & purification*
  • Feces / microbiology
  • Female
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Prevalence
  • Retrospective Studies
  • Statistics as Topic
  • Vancomycin Resistance*

Substances

  • Anti-Bacterial Agents