Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients
Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients
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DOI：
10.1086/314898
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发表时间：
1999-08-01
影响因子：
6.4
通讯作者：
Jarvis, WR
中科院分区：
文献类型：
--
作者：
Trick, WE;Kuehnert, MJ;Jarvis, WR
1997年初，苏州苏克斯兰区卫生局(SDHD；苏城，亚利桑那州)报告说，该地区卫生保健机构的万古霉素耐药肠球菌(VRE)分离率有所增加。为确定SDHD地区32个卫生机构VRE菌株的流行率和定植危险因素，开展了流行调查和病例对照研究。在2266名患者和居民中，1934人(85%)参与其中，40人(2.1%)(胃肠道)VRE定植阳性。急性护理机构(ACF)的VRE分离率显著高于长期护理机构(10/152[6.6%]比30/1782[1.7%]；优势比[OR]为4.1；95%可信区间[CI]为1.8-9.0)。LTCF患者在任何ACF住院的可能性显著高于对照组(19/30 vs，12/66；OR，8.0；95%CI，2.7-23.8)。在40株VRE分离株中，34株(85%)为相关株。优势菌株存在于所有12个LTCFs中，每个机构至少有1名患者。在将VRE分离株引入该地区后不久，由于居民从ACF向LTCFs的转移，传播到多个LTCFs。
During early 1997, the Siouxland District Health Department (SDHD; Sioux City, IA) reported an increased incidence of vancomycin-resistant enterococcal (VRE) isolates at area health care facilities. To determine the prevalence and risk factors for colonization with VRE strains at 32 health care facilities in the SDHD region, a prevalence survey and case-control study were performed. Of 2266 patients and residents, 1934 (85%) participated, and 40 (2.1%) were positive for (gastrointestinal) VRE colonization. The prevalence of VRE isolates was significantly higher in acute care facilities (ACFs) than in long-term care facilities (LTCFs) (10/152 [6.6%] vs, 30/1782 [1.7%]; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.8-9.0). LTCF case patients were significantly more likely than controls to have been inpatients at any ACF (19/30 vs, 12/66; OR, 8.0; 95% CI, 2.7-23.8). Of 40 VRE isolates, 34 (85%) were a related strain. The predominant strain was present in all 12 LTCFs that had at least 1 case patient in each facility. Soon after the introduction of VRE isolates into this region, dissemination to multiple LTCFs resulted from resident transfer from ACFs to LTCFs.