Vancomycin-resistant Enterococcus faecium: admission prevalence, sequence types and risk factors-a cross-sectional study in seven German university hospitals from 2014 to 2018

被引：10

作者：

Rohde, Anna M. ^{[1
,2
,3
,4
,5
]}

Walker, Sarah ^{[1
,6
,7
]}

Behnke, Michael ^{[1
,2
,3
,4
,5
]}

Eisenbeis, Simone ^{[1
,8
]}

Falgenhauer, Linda ^{[1
,9
]}

Falgenhauer, Jane C. ^{[1
,10
]}

Haecker, Georg ^{[1
,11
]}

Hoelzl, Florian ^{[1
,8
,12
]}

Imirzalioglu, Can ^{[1
,10
]}

Kaeding, Nadja ^{[1
,13
]}

Kern, Winfried, V ^{[1
,14
,15
]}

Kola, Axel ^{[1
,2
,3
,4
,5
]}

Kramme, Evelyn ^{[1
,13
]}

Mischnik, Alexander ^{[1
,13
]}

Peter, Silke ^{[1
,12
]}

Rieg, Siegbert ^{[1
,14
,15
]}

Rupp, Jan ^{[1
,13
]}

Schneider, Christian ^{[1
,11
]}

Schwab, Frank ^{[1
,2
,3
,4
,5
]}

Seifert, Harald ^{[1
,6
,7
]}

Tacconelli, Evelina ^{[1
,8
]}

Tobys, David ^{[1
,6
,7
]}

Trauth, Janina ^{[1
,16
]}

Weber, Anna ^{[1
,2
,3
,4
,5
]}

Xanthopoulou, Kyriaki ^{[1
,6
,7
]}

Zweigner, Janine ^{[1
,17
]}

Higgins, Paul G. ^{[1
,6
,7
]}

Gastmeier, Petra ^{[1
,2
,3
,4
,5
]}

机构：

[1] German Ctr Infect Res DZIF, Braunschweig, Germany

[2] Charite Univ Med Berlin, Inst Hyg & Environm Med, Berlin, Germany

[3] Free Univ Berlin, Berlin, Germany

[4] Humboldt Univ, Berlin, Germany

[5] Berlin Inst Hlth, Berlin, Germany

[6] Univ Cologne, Inst Med Microbiol Immunol & Hyg, Fac Med, Cologne, Germany

[7] Univ Hosp Cologne, Univ Cologne, Cologne, Germany

[8] Univ Hosp Tubingen, Dept Internal Med 1, Div Infect Dis, Tubingen, Germany

[9] Justus Liebig Univ, Inst Hyg & Environm Med, Giessen, Germany

[10] Justus Liebig Univ, Inst Med Microbiol, Giessen, Germany

[11] Univ Freiburg, Univ Med Ctr Freiburg, Inst Med Microbiol & Hyg, Fac Med, Freiburg, Germany

[12] Univ Tubingen, Inst Med Microbiol & Hyg, Tubingen, Germany

[13] Univ Hosp Schleswig Holstein Campus, Dept Infect Dis & Microbiol, Lubeck, Germany

[14] Albert Ludwigs Univ, Univ Med Ctr, Dept Med 2, Div Infect Dis, Freiburg, Germany

[15] Albert Ludwigs Univ, Fac Med, Freiburg, Germany

[16] Uniklinikum, Dept Internal Med Infect, Giessen, Germany

[17] Univ Hosp Cologne, Dept Hosp Hyg & Infect Control, Cologne, Germany

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2023年 / 29卷 / 04期

关键词：

Admission prevalence; Colonization; Risk factors; ST117; VREfm; INTENSIVE-CARE; COLONIZATION; EPIDEMIOLOGY; INFECTION; OUTBREAKS; BACTERIA;

D O I：

10.1016/j.cmi.2022.11.025

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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.

引用

页码：515 / 522

页数：8

共 39 条

[1] Whole-genome sequencing revealed independent emergence of vancomycin-resistant Enterococcus faecium causing sequential outbreaks over 3years in a tertiary care hospital [J].

Abdelbary, Mohamed H. H. ;

Senn, Laurence ;

Greub, Gilbert ;

Chaillou, Gregory ;

Moulin, Estelle ;

Blanc, Dominique S. .

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2019, 38 (06) :1163-1170

[2] The Association of Climatic Factors with Rates of Surgical Site Infections [J].

Aghdassi, Seven Johannes Sam ;

Schwab, Frank ;

Hoffmann, Peter ;

Gastmeier, Petra .

DEUTSCHES ARZTEBLATT INTERNATIONAL, 2019, 116 (31-32) :529-+

[3] The rise of the Enterococcus: beyond vancomycin resistance [J].

Arias, Cesar A. ;

Murray, Barbara E. .

NATURE REVIEWS MICROBIOLOGY, 2012, 10 (04) :266-278

[4] Effect of meteorological factors and geographic location on methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization in the US [J].

Blanco, Natalia ;

Perencevich, Eli ;

Li, Shan Shan ;

Morgan, Daniel J. ;

Pineles, Lisa ;

Johnson, J. Kristie ;

Robinson, Gwen ;

Anderson, Deverick J. ;

Jacob, Jesse T. ;

Maragakis, Lisa L. ;

Harris, Anthony D. .

PLOS ONE, 2017, 12 (05)

[5] Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms [J].

Cassone, Marco ;

Mantey, Julia ;

Gontjes, Kyle J. ;

Lansing, Bonnie J. ;

Gibson, Kristen E. ;

Wang, Joyce ;

Mody, Lona .

FRONTIERS IN PUBLIC HEALTH, 2021, 9

[6] Core Genome Multilocus Sequence Typing Scheme for High-Resolution Typing of Enterococcus faecium [J].

de Been, Mark ;

Pinholt, Mette ;

Top, Janetta ;

Bletz, Stefan ;

Mellmann, Alexander ;

van Schaik, Willem ;

Brouwer, Ellen ;

Rogers, Malbert ;

Kraat, Yvette ;

Bonten, Marc ;

Corander, Jukka ;

Westh, Henrik ;

Harmsen, Dag ;

Willems, Rob J. L. .

JOURNAL OF CLINICAL MICROBIOLOGY, 2015, 53 (12) :3788-3797

[7]

European Centre for Disease Prevention and Control, 2019, Surveillance of antimicrobial resistance in Europe 2018

[8] Changing epidemiology of vancomycin-resistant Enterococcus faecium: Results of a genome-based study at a regional neurological acute hospital with intensive care and early rehabilitation treatment [J].

Falgenhauer, Linda ;

Preuser, Ingeborg ;

Imirzalioglu, Can ;

Falgenhauer, Jane ;

Fritzenwanker, Moritz ;

Mack, Dietrich ;

Best, Christoph ;

Heudorf, Ursel ;

Chakraborty, Trinad .

INFECTION PREVENTION IN PRACTICE, 2021, 3 (02)

[9] Near-ubiquitous presence of a vancomycin-resistant Enterococcus faecium ST117/CT71/vanB -clone in the Rhine-Main metropolitan area of Germany [J].

Falgenhauer, Linda ;

Fritzenwanker, Moritz ;

Imirzalioglu, Can ;

Steul, Katrin ;

Scherer, Marlene ;

Heudorf, Ursel ;

Chakraborty, Trinad ;

Albert-Braun, Sabine ;

Hunfeld, Klaus-Peter ;

Kempf, Volkhard ;

Kneifel, Andreas ;

Kukic, Adnan ;

Jahn-Muehl, Bernhard ;

Madlener, Katharina ;

Oberdorfer, Klaus ;

Oeltze, Joern-Peter ;

Schulze, Joerg ;

Sotoudeh, Navid ;

Tessmann, Rolf .

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 2019, 8 (1)

[10] Recommendations for the successful control of a large outbreak of vancomycin-resistant Enterococcus faecium in a non-endemic hospital setting [J].

Frakking, F. N. J. ;

Bril, W. S. ;

Sinnige, J. C. ;

van't Klooster, J. E. ;

de Jong, B. A. W. ;

van Hannen, E. J. ;

Tersmette, M. .

JOURNAL OF HOSPITAL INFECTION, 2018, 100 (04) :E216-E225

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