Hospital acquired vancomycin resistant enterococci in surgical intensive care patients - a prospective longitudinal study.

Autor:	Kampmeier S; 1Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149 Münster, Germany., Kossow A; 1Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149 Münster, Germany., Clausen LM; 1Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149 Münster, Germany., Knaack D; 2Institute of Medical Microbiology, University Hospital Münster, Münster, Germany., Ertmer C; 3Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany., Gottschalk A; 3Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany., Freise H; 3Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany., Mellmann A; 1Institute of Hygiene, University Hospital Münster, Robert-Koch-Strasse 41, 48149 Münster, Germany.
Jazyk:	angličtina
Zdroj:	Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2018 Aug 23; Vol. 7, pp. 103. Date of Electronic Publication: 2018 Aug 23 (Print Publication: 2018).
DOI:	10.1186/s13756-018-0394-1
Abstrakt:	Background: Vancomycin resistant enterococci (VRE) occur with enhanced frequency in hospitalised patients. This study elucidates the prevalence of VRE on admission among surgical intensive care unit (SICU) patients, whether these patients are at special risk for VRE acquisition and which risk factors support this process. Methods: Patients admitted to SICUs of the University Hospital Münster were examined during August-October 2017. VRE screening was performed within 48 h after admission and directly prior to discharge of patients. In parallel risk factors were recorded to estimate their effect on VRE acquisition during SICU stay. Results: In total, 374 patients (68% male) with a median age of 66 years were admitted to one of the SICUs during the investigation period. Of all, 336 patients (89.8%) were screened on admission and 268 (71.7%) on discharge. Nine patients were admitted with previously known VRE colonisation. Twelve (3.6%) further patients were VRE positive on admission. During ICU stay, eight (3.0%) additional patients turned out to be VRE colonised. Risk factors found to be significantly associated with VRE acquisition were median length of stay on the ICU (14 vs. 3 days; p  = 0.01), long-term dialysis (12.5% vs. 2.0% of patients; p  = 0.05), and antibiotic treatment with flucloxacillin (28.6% vs. 7.2% of patients; p  = 0.01) or piperacillin/tazobactam (57.1% vs. 26.6% of patients; p  = 0.01). Conclusions: SICU patients are not at special risk for VRE acquisition. Previous stay on a SICU should therefore not be considered as specific risk factor for VRE colonisation. Competing Interests: All strategies and investigations were performed in accordance with the recommendations for cluster detections of nosocomial infections of the legally assigned institute for infection control and prevention (Robert Koch Institute). Present analysis was performed after cluster of VRE in SICU patients. Formal consent was therefore not required.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Databáze:	MEDLINE
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