Risk factors for vancomycin-resistant enterococcus acquisition during a large outbreak in patients aged 65 years and older

Abstract

BackgroundIn the context of an aging population, identifying risk factors for Vancomycin-resistant enterococci (VRE), specific to older people, is important. However, if age is a known risk factor for VRE infection, a limited number of studies have focused on older patients. This study aimed to identify potential risk factors for VRE acquisition in a population aged 65 years and older, during a large VRE outbreak that occurred in a teaching hospital in Lyon, France, from December 2013 to July 2014.MethodsThe present retrospective, multi-center, descriptive, and analytical study used part of a previous cohort, and included only a sub-group of patients aged 65 years and older. The analysis of the factors included in the original study was completed with factors more specific to geriatric patients. Inclusion criteria were patients aged 65 years and older, in contact with a VRE index patient. Patients were screened by rectal swabs. Univariate and multivariate logistic regression analyses were performed.ResultsA total of 180 VRE contacts were included and 18 patients became carriers. Multivariate analysis showed that risk factors for VRE acquisition in older people included major contact type (RR: 5.31, 95%CI [1.33; 21.19]), number of antibiotics used (RR: 1.36, 95%CI [1.04; 1.76]), a score of McCabe = 2 (RR: 116.39, 95%CI [5.52; 2455.98]), ethylism (RR: 5.50, 95%CI [1.49; 20.25]), and dementia (RR: 7.50, 95%CI [1.89; 29.80]).ConclusionsThis study was able to demonstrate risk factors for VRE acquisition in older people. These risk factors should be taken into account when in the presence of older people in a VRE infected unit.

No Effect of Lactobacillus rhamnosus GG on Eradication of Colonization by Vancomycin-Resistant Enterococcus faecium or Microbiome Diversity in Hospitalized Adult Patients

“…Of interest and in line with previous studies, longer hospitalization and treatment with vancomycin or metronidazole was significantly associated with nonclearing of VREfm ( 37 , 38 ). Antibiotics that specifically kill anaerobic bacteria, like metronidazole, have been shown to dispose hospitalized patients to density of VREfm colonization ( 39 ).…”

Increasing Trend of Vancomycin-resistant Enterococci Bacteremia in a Tertiary Care Hospital of South India: A Three-year Prospective Study

“… 11 , 21 Common risk factors for VRE colonization and bacteremia include immunosuppression, neutropenia, renal insufficiency, prolonged hospital stay, ICU admission, staying in close proximity to a VRE patient, and extensive antimicrobial use. 22 , 23 …”

Molecular epidemiology of vancomycin-resistant Enterococcus faecium clinical isolates in a tertiary care hospital in southern Thailand: a retrospective study

“…Nearly 50% of VRE carrier patients were ≥65 years old, with a median age of 64 years, and were admitted to the medical ward. In a 2019 study by Mathis et al, older patients had the highest infection during VRE outbreak in 2013–2014 at a teaching hospital in Lyon, France ( Mathis et al, 2019 ).…”