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Risk Factors for Long-Term Vancomycin-Resistant Enterococci Persistence-A Prospective Longitudinal Study.

Carlos L Correa-Martinez1, Verena B Stollenwerk2, Annelene Kossow3

  • 1Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany. Carlos.Correa@ukmuenster.de.

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|September 29, 2019
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Summary

Most patients (56.4%) cleared vancomycin-resistant enterococci (VRE) carriage. Prolonged VRE persistence was linked to frequent, long hospital stays, hemato-oncological diseases, steroid use, and antibiotics.

Keywords:
Vancomycin-resistant enterococci (VRE)persistencerisk factorswhole genome sequencing

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Healthcare Epidemiology

Background:

  • Vancomycin-resistant enterococci (VRE) are significant healthcare-associated pathogens.
  • Effective infection control for VRE remains a challenge for healthcare systems.
  • Understanding VRE carriage duration and clearance is crucial for patient management.

Purpose of the Study:

  • To identify risk factors for prolonged vancomycin-resistant enterococci (VRE) carriage.
  • To determine the rate of VRE clearance enabling discontinuation of contact precautions.
  • To inform targeted infection control strategies for patients with VRE history.

Main Methods:

  • Prospective screening of at-risk patients over 2 years.
  • Bacterial identification, antibiotic susceptibility testing, and PCR for glycopeptide resistance.
  • Whole genome sequencing for isolate comparison and follow-up screening upon readmission.

Main Results:

  • Of 463 patients with assessed carriage status, 56.4% cleared VRE.
  • Long-term VRE persistence was associated with frequent/long hospital stays, hemato-oncological diseases, systemic steroid use, and antibiotic exposure.
  • No genotypic clustering differentiated VRE clearance from persistence.

Conclusions:

  • VRE clearance may be underestimated in clinical settings.
  • Identifying risk factors for prolonged carriage can guide targeted infection control for readmitted patients.
  • This knowledge supports optimized resource allocation for VRE prevention.