Duration of colonization with vancomycin-resistant Enterococcus
Duration of colonization with vancomycin-resistant Enterococcus
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DOI：
10.1086/502036
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发表时间：
2002-04-01
影响因子：
4.5
通讯作者：
Farr, BM
中科院分区：
文献类型：
--
作者：
Byers, KE;Anglim, AM;Farr, BM
目的：确定万古霉素耐药肠球菌（VRE）定植的持续时间和连续3次阴性培养确定清除率的充分性。设计：回顾性队列研究。地点：一所大学医院。人群：经直肠周围培养确定为VRE携带者并进行随访培养的患者。方法：当患者未接受对VRE具有活性的抗生素时，在住院和门诊环境中收集随访直肠周培养物，间隔至少1周。培养阳性的可能性进行了分析，从最初的阳性culture.RESULTS：共116例VRE定植的患者有423后续文化，平均204天（范围，4至709天）后，他们最初的隔离。第一次随访培养，平均125天后收集的初始阳性分离株，是阴性的64%。在1次阴性随访培养后，92%的患者的下一次阴性。在2次阴性培养后，95%仍为培养阴性。在3次连续阴性培养后，37例患者中有35例（95%）仍为培养阴性。随着初始分离株和后续分离株之间间隔时间的增加，后续培养阳性的概率降低（P
OBJECTIVE: To determine the duration of colonization with vancomycin-resistant Enterococcus (VRE) and the adequacy of 3 consecutive negative cultures to determine clearance.DESIGN: Retrospective cohort study.SETTING: A university hospital.POPULATION: Patients identified by perirectal cultures as VRE carriers who had follow-up cultures.METHODS: Follow-up perirectal cultures were collected in inpatient and outpatient settings, at least 1 week apart, when patients were not receiving antibiotics with activity against VRE. The likelihood of culture positivity was analyzed given prior culture results and time from the initial positive culture.RESULTS: A total of 116 patients colonized with VRE had 423 follow-up cultures, a mean of 204 days (range, 4 to 709 days) after their initial isolate. The first follow-up culture, collected a mean of 125 days after the initial positive isolate, was negative in 64%. After 1 negative follow-up culture, the next one was negative in 92% of the patients. After 2 negative cultures, 95% remained culture-negative. After 3 sequential negative cultures, 35 (95%) of 37 patients remained culture-negative. As the interval between the initial and the follow-up isolates increased, the probability that a subsequent culture would be positive decreased (P