Previous antibiotic therapy as independent risk factor for the presence of vancomycin-resistant enterococci in surgical inpatients. Results from a matched case-control study

BMC Infect Dis. 2023 May 2;23(1):274. doi: 10.1186/s12879-023-08238-4.

Abstract

Background: Investigation of risk factors for the presence of vancomycin-resistant enterococci (VRE) in inpatients on surgical wards and associated intensive care units of a German tertiary care hospital.

Methods: A single-centre retrospective matched case-control study was performed with surgical inpatients admitted between July 2013 and December 2016. Patients with in-hospital detection of VRE later than 48 h after admission were included and comprised 116 VRE-positive cases and 116 VRE-negative matched controls. VRE isolates of cases were typed by multi-locus sequence typing.

Results: ST117 was identified as the dominant VRE sequence type. Next to length of stay in hospital or on an intensive care unit and previous dialysis the case-control study revealed previous antibiotic therapy as a risk factor for the in-hospital detection of VRE. The antibiotics piperacillin/tazobactam, meropenem, and vancomycin were associated with the highest risks. After taking into account length of stay in hospital as possible confounder other potential contact-related risk factors such as previous sonography, radiology, central venous catheter, and endoscopy were not significant.

Conclusions: Previous dialysis and previous antibiotic therapy were identified as independent risk factors for the presence of VRE in surgical inpatients.

Keywords: Case control study; Risk-factors; Surgical patients; Vancomycin-resistant enterococci.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Case-Control Studies
  • Cross Infection* / drug therapy
  • Cross Infection* / epidemiology
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / epidemiology
  • Humans
  • Inpatients
  • Multilocus Sequence Typing
  • Retrospective Studies
  • Risk Factors
  • Vancomycin-Resistant Enterococci* / genetics

Substances

  • Anti-Bacterial Agents