Trends and Risk Factors for Healthcare-Associated Vancomycin-Resistant Enterococci of Urinary Tract Infections in Taiwan

Abstract

Purpose: Vancomycin can be used to treat many bacterial infections, although the generation of vancomycin-resistant Enterococci (VRE) may cause adverse consequences. We analysed the trends and the risk factors for healthcare-associated urinary tract infections (UTIs) by VRE. Methods: This retrospective study included patients who were hospitalized from 2009–2015 and had hospital-acquired enterococci infections who fulfilled the Centers for Disease Control and Ministry of Health and Welfare criteria, as determined by infection control professionals. Results: The mean age of the 594 participants was 72.3 years. The proportion of men with enterococcal UTIs was 70%. The proportion of VRE infections among all enterococcal UTIs was lowest in 2009 (18.1%) and highest in 2015 (47.3%). An increasing trend in the proportion of patients with VRE UTIs was observed from 2009–2015. Length of hospitalization of more than 40 days, placement of double-lumen catheters, and placement of a nasogastric tube were associated with a higher risk of VRE in UTIs (odds ratio=1.93–2.72, all P <.05). Conclusions: The use of unnecessary invasive catheters in patients with double-lumen catheters or nasogastric tubes should be reduced. Environmental disinfection and hand hygiene should be implemented.