Implications for vancomycin-resistant Enterococcus colonization associated with Clostridium difficile infections
| Autor: | Stephen G. Nichols, Margie A. Morgan, A. Rekha Murthy, W. Lance George, Shigeki Fujitani |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Epidemiology medicine.drug_class Antibiotics medicine.disease_cause Microbiology Feces Risk Factors Medicine Humans Vancomycin-resistant Enterococcus Colonization Gram-Positive Bacterial Infections Aged Aged 80 and over biology business.industry Clostridioides difficile Health Policy Public Health Environmental and Occupational Health Vancomycin Resistance biochemical phenomena metabolism and nutrition Clostridium difficile Middle Aged Staphylococcal Infections bacterial infections and mycoses biology.organism_classification medicine.disease Metronidazole Infectious Diseases Enterococcus Carrier State Coinfection Vancomycin Female business medicine.drug Acinetobacter Infections |
| Zdroj: | American journal of infection control. 39(3) |
| ISSN: | 1527-3296 |
| Popis: | Background Vancomycin-resistant Enterococcus (VRE) colonization of the gastrointestinal tract shares similar risk factors with Clostridium difficile infection. We sought to elucidate the prevalence and risk factors of VRE colonization associated with C difficile infection. Methods All adult inpatients with C difficile infection from July 2006 to October 2006 were prospectively evaluated. All C difficile toxin-positive stool samples were screened for detection of VRE. Risk factors for VRE colonization were compared in patients with C difficile infection with and without VRE colonization. Results Of the 158 cases of C difficile infection evaluated, 88 (55.7%) involved VRE colonization. Independent risk factors for VRE colonization were admission from long-term care facilities ( P = .013), dementia ( P = .017), and hospitalization in the previous 2 months ( P = .014). No statistically significant difference between C difficile infection cases with and without VRE colonization in terms of previous receipt (within 1 month) of antibiotics, including metronidazole and vancomycin, was found on multivariate analysis. C difficile infection cases with VRE colonization had a higher prevalence of coinfection with methicillin-resistant Staphylococcus aureus ( P = .002) and Acinetobacter spp ( P = .006). Conclusion VRE colonization was associated with >50% of C difficile infection cases and with a higher rate of coinfection with multidrug-resistant pathogens. Given the high rate of C difficile infection associated with VRE colonization, active surveillance of VRE in patients with C difficile infection is reasonable in high-risk settings. |
| Databáze: | OpenAIRE |
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