Sook-Jin Byun; Jiyeon Kang

doi:10.4040/jkan.2013.43.2.287

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Original Article
Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission: Sook-Jin Byun, Jiyeon Kang; Journal of Korean Academy of Nursing 2013;43(2):287-295.
DOI: https://doi.org/10.4040/jkan.2013.43.2.287
Published online: April 30, 2013

¹Infection Control Team, Dong-A University Medical Center, Busan, Korea.

²Department of Nursing, Dong-A University, Busan, Korea.

Address reprint requests to: Kang, Jiyeon. Department of Nursing, Dong-A University, 1 Dongdaesin-dong, 3-ga, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2871, Fax: +82-51-240-2920, jykang@dau.ac.kr

• Received: September 27, 2012 • Accepted: January 24, 2013

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization.
Methods
Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method.
Results
During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality.
Conclusion
Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.
Keywords: Vancomycin resistance; Enterococcus; Infection control; Intensive care units

This manuscript is a revision of the first author's master's thesis from Dong-A University.

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Table 1

Characteristics of Study Patients

ICU=Intensive care unit; COPD=Chronic obstructive pulmonary disease.

^*After propensity score matching (N =398)

Table 2

Factors Influencing VRE Colonization

MRSA=Methicillin resistant staphylococcus aureus.

Table 3

Multivariate Analysis of Risk Factors for VRE Colonization

OR=Odds ratio; 95% CI=5% confidence interval to OR; MRSA=Methicillin resistant staphylococcus aureus.

Table 4

Comparison of Clinical Outcomes between VRE Colonized and Uncolonized Groups

^*Multiple checks allowed; ICU=Intensive care unit.

Figure & Data

REFERENCES

Citations

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Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission

J Korean Acad Nurs. 2013;43(2):287-295. Published online April 30, 2013

DOI: https://doi.org/10.4040/jkan.2013.43.2.287

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Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission

Table 1

Characteristics of Study Patients

ICU=Intensive care unit; COPD=Chronic obstructive pulmonary disease.

^*After propensity score matching (N =398)

Table 2

Factors Influencing VRE Colonization

MRSA=Methicillin resistant staphylococcus aureus.

Table 3

Multivariate Analysis of Risk Factors for VRE Colonization

OR=Odds ratio; 95% CI=5% confidence interval to OR; MRSA=Methicillin resistant staphylococcus aureus.

Table 4

Comparison of Clinical Outcomes between VRE Colonized and Uncolonized Groups

^*Multiple checks allowed; ICU=Intensive care unit.

Table 1 Characteristics of Study Patients

ICU=Intensive care unit; COPD=Chronic obstructive pulmonary disease.

^*After propensity score matching (N =398)

Table 2 Factors Influencing VRE Colonization

MRSA=Methicillin resistant staphylococcus aureus.

Table 3 Multivariate Analysis of Risk Factors for VRE Colonization

OR=Odds ratio; 95% CI=5% confidence interval to OR; MRSA=Methicillin resistant staphylococcus aureus.

Table 4 Comparison of Clinical Outcomes between VRE Colonized and Uncolonized Groups