Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia.
Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia.
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DOI：
10.1186/1471-2334-14-353
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发表时间：
2014-06-28
影响因子：
3.7
通讯作者：
Kong DC
中科院分区：
文献类型：
--
作者：
Cheah AL;Peel T;Howden BP;Spelman D;Grayson ML;Nation RL;Kong DC
肠球菌是卫生保健相关感染的主要原因。在澳大利亚，vanB万古霉素耐药肠球菌（VRE）是主要的基因型。与vanB VRE菌血症相关的因素的数据有限。本研究旨在确定与vanB VRE菌血症相关的因素，并将其与万古霉素敏感肠球菌（VSE）菌血症进行比较。在澳大利亚维多利亚的两家三级公立医院进行了病例-病例-对照研究。将VRE和VSE菌血症病例与无肠球菌菌血症证据但可能有其他病原体感染的对照组进行比较。所有VRE分离株均为vanB基因型。与vanB VRE菌血症相关的因素是最近30天内使用导尿管（OR 2.86，95%CI 1.09-7.53），甲硝唑治疗持续时间增加（OR 1.65，95%CI 1.17-2.33），以及VRE特异性慢性病评分较高（OR 1.70，95%CI 1.05-2.77）。与VSE菌血症相关的因素是胃肠道疾病史（OR 2.29，95%CI 1.05-4.99）和甲硝唑治疗持续时间的增加（OR 1.23，95%CI 1.02-1.48）。进入血液学/肿瘤科与VSE菌血症的几率较低相关（OR 0.08，95%CI 0.01-0.74）。这是涉及vanB VRE菌血症的最大规模病例-病例-对照研究。与vanB VRE菌血症发生相关的因素与VSE菌血症不同。
Enterococci are a major cause of healthcare-associated infection. In Australia, vanB vancomycin-resistant enterococci (VRE) is the predominant genotype. There are limited data on the factors linked to vanB VRE bacteraemia. This study aimed to identify factors associated with vanB VRE bacteraemia, and compare them with those for vancomycin-susceptible enterococci (VSE) bacteraemia. A case-case-control study was performed in two tertiary public hospitals in Victoria, Australia. VRE and VSE bacteraemia cases were compared with controls without evidence of enterococcal bacteraemia, but may have had infections due to other pathogens. All VRE isolates had vanB genotype. Factors associated with vanB VRE bacteraemia were urinary catheter use within the last 30 days (OR 2.86, 95% CI 1.09-7.53), an increase in duration of metronidazole therapy (OR 1.65, 95% CI 1.17-2.33), and a higher Chronic Disease Score specific for VRE (OR 1.70, 95% CI 1.05-2.77). Factors linked to VSE bacteraemia were a history of gastrointestinal disease (OR 2.29, 95% CI 1.05-4.99) and an increase in duration of metronidazole therapy (OR 1.23, 95% CI 1.02-1.48). Admission into the haematology/oncology unit was associated with lower odds of VSE bacteraemia (OR 0.08, 95% CI 0.01-0.74). This is the largest case-case-control study involving vanB VRE bacteraemia. Factors associated with the development of vanB VRE bacteraemia were different to those of VSE bacteraemia.