Journal article

Publication year: 2023

Pages: 515-522

Journal: Clinical Microbiology and Infection

Volume number: 29

Issue number: 4

ISSN: 1198-743X

eISSN: 1469-0691

Open access status: Bronze

DOI Link: https://doi.org/10.1016/j.cmi.2022.11.025

Publisher: Elsevier

Abstract: 
Objectives: Assessment of vancomycin-resistant Enterococcus faecium (VREfm) prevalence upon hospital admission and analysis of risk factors for colonization. Methods: From 2014 to 2018, patients were recruited within 72 hours of admission to seven participating German university hospitals, screened for VREfm and questioned for potential risk factors (prior multidrug-resistant organism detection, current/prior antibiotic consumption, prior hospital, rehabilitation or long-term care facility stay, international travel, animal contact and proton pump inhibitor [PPI]/antacid therapy). Genotype analysis was done using cgMLST typing. Multivariable analysis was performed. Results: In 5 years, 265 of 17,349 included patients were colonized with VREfm (a prevalence of 1.5%). Risk factors for VREfm colonization were age (adjusted OR [aOR], 1.02; 95% CI, 1.01-1.03), previous (aOR, 2.71; 95% CI, 1.87-3.92) or current (aOR, 2.91; 95% CI, 2.60-3.24) antibiotic treatment, prior multidrugresistant organism detection (aOR, 2.83; 95% CI, 2.21-3.63), prior stay in a long-term care facility (aOR, 2.19; 95% CI, 1.62-2.97), prior stay in a hospital (aOR, 2.91; 95% CI, 2.05-4.13) and prior consumption of PPI/antacids (aOR, 1.29; 95% CI, 1.18-1.41). Overall, the VREfm admission prevalence increased by 33% each year and 2% each year of life. 250 of 265 isolates were genotyped and 141 (53.2%) of the VREfm were the emerging ST117. Multivariable analysis showed that ST117 and non-ST117 VREfm colonized patients differed with respect to admission year and prior multidrug-resistant organism detection. Discussion: Age, healthcare contacts and antibiotic and PPI/antacid consumption increase the individual risk of VREfm colonization. The VREfm admission prevalence increase in Germany is mainly driven by the emergence of ST117. Anna M. Rohde, Clin Microbiol Infect 2023;29:515 (c) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Harvard Citation style: Rohde, A., Walker, S., Behnke, M., Eisenbeis, S., Falgenhauer, L., Falgenhauer, J., et al. (2023) Vancomycin-resistant Enterococcus faecium: admission prevalence, sequence types and risk factors-a cross-sectional study in seven German university hospitals from 2014 to 2018, Clinical Microbiology and Infection, 29(4), pp. 515-522. https://doi.org/10.1016/j.cmi.2022.11.025

APA Citation style: Rohde, A., Walker, S., Behnke, M., Eisenbeis, S., Falgenhauer, L., Falgenhauer, J., Haecker, G., Hoelzl, F., Imirzalioglu, C., Kaeding, N., Kern, W., Kola, A., Kramme, E., Mischnik, A., Peter, S., Rieg, S., Rupp, J., Schneider, C., Schwab, F., ...Gastmeier, P. (2023). Vancomycin-resistant Enterococcus faecium: admission prevalence, sequence types and risk factors-a cross-sectional study in seven German university hospitals from 2014 to 2018. Clinical Microbiology and Infection. 29(4), 515-522. https://doi.org/10.1016/j.cmi.2022.11.025