國家衛生研究院 NHRI:Item 3990099045/12378

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Title:	Predictors for vancomycin resistant Enterococcus faecium transforming from colonization to infection: A case control study
Authors:	Chen, PY;Chuang, YC;Wang, JT;Sheng, WH;Chen, YC;Chang, SC
Contributors:	National Institute of Infectious Diseases and Vaccinology
Abstract:	Background Little is known about risk factors for subsequent infections among vancomycin resistant Enterococcus faecium (VREfm) colonizers, especially characterized by concordant pulsotypes (CP) of paired colonization and infection-related isolates. Methods This case-control study was conducted at a teaching hospital between 2011 and 2014. Targeted patients received active surveillance culture for VREfm by anal swabs at admission. Cases were those who developed VREfm infection within 180 days after colonization of VREfm. Controls were those colonized with VREfm without subsequent VREfm infection. CP were defined by similarities >= 86.7% using pulsed-field gel electrophoresis between paired colonization and infection-related isolates. Results Ninety-seven cases and 194 controls were enrolled. By conditional multivariable logistic regression analysis, the risk factors for subsequent infection among VREfm colonizers were intensive care unit (ICU) admission (adjusted odds ratio [aOR], 9.32; 95% CI, 3.61-24.02), receipt of central venous catheters (CVC) (aOR, 3.38; 95% CI, 1.30-8.82), and utilization of third- and fourth-generation cephalosporins (aOR, 4.06; 95% CI, 1.79-9.20, and aOR, 5.32; 95% CI, 1.85- 10.29, respectively) (all P <= 0.01). Fifty-six (57.7%) of case patients belonged to the CP group, which were associated with ICU admission (aOR, 3.74; 95% CI, 1.38-10.13), and infection developing within 30 days after colonization (aOR, 3.34; 95% CI, 1.25-8.91). Conclusions Among VREfm colonizers, being admitted to ICU and receiving CVC or broad spectrum cephalosporins, were the risk factors for subsequent infections. These findings highlight the importance of conducting more strict infection control measures on specific groups of VREfm colonizers.
Date:	2019-12
Relation:	Antimicrobial Resistance and Infection Control. 2019 Dec;8:Article number 196.
Link to:	http://dx.doi.org/10.1186/s13756-019-0647-7
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2047-2994&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000500997100001
Cited Times(Scopus):	https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85076231419
Appears in Collections:	[Yee-Chun Chen] Periodical Articles

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