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A case-control study to detect modifiable risk factors for colonization with vancomycin-resistant enterococci.

M Loeb1, S Salama, M Armstrong-Evans

  • 1Department of Laboratory Medicine, Hamilton Health Sciences Corporation and McMaster University, Ontario, Canada.

Infection Control and Hospital Epidemiology
|December 2, 1999
PubMed
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Cephalosporin antibiotic use significantly increased the risk of vancomycin-resistant Enterococcus (VRE) colonization during a hospital outbreak. This study identified cephalosporins as a key modifiable risk factor, not nursing workload.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Clinical Microbiology

Background:

  • Vancomycin-resistant Enterococcus (VRE) poses a significant threat in healthcare settings.
  • Hospital outbreaks necessitate rapid identification of modifiable risk factors for effective control.
  • Understanding colonization dynamics is crucial for preventing VRE transmission.

Purpose of the Study:

  • To identify modifiable risk factors for vancomycin-resistant Enterococcus (VRE) colonization.
  • To investigate the association between specific antibiotic use and VRE colonization during a hospital outbreak.
  • To determine if nursing workload intensity is a risk factor for VRE colonization.

Main Methods:

  • A case-control study design was employed.
  • Data were collected during a VRE hospital outbreak.

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  • Statistical analysis, including odds ratios and confidence intervals, was used to assess risk factors.

    • Main Results:

    • Cephalosporin antibiotic use was identified as the sole independent risk factor for VRE colonization (OR, 13.8; 95% CI, 2.5-76.3; P = .01).
    • Nursing workload intensity did not show a statistically significant association with VRE colonization in this study.
    • The findings highlight a specific antibiotic class linked to increased VRE risk.

    Conclusions:

    • Cephalosporin administration is a critical, modifiable risk factor for VRE colonization during hospital outbreaks.
    • Targeted antimicrobial stewardship interventions focusing on cephalosporin use may help mitigate VRE spread.
    • Nursing workload is not a significant driver of VRE colonization, suggesting other factors are more influential.