Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study

Area of Science:

• Medical microbiology
• Epidemiology
• Public health

Background:

• Vancomycin-resistant enterococci (VRE) pose a significant global health threat.
• Understanding factors influencing VRE incidence is crucial for control strategies.

Purpose of the Study:

• To investigate the correlation between VRE incidence and demographic and climatic factors.
• To identify key drivers of vancomycin resistance in enterococci.

Main Methods:

• Retrospective analysis of data from January 2014 to December 2021.
• Statistical analyses including Spearman's rank correlation, beta regression, and spatial analysis.
• Utilized R version 4.2.2 and ArcGIS version 10.7 for data analysis.

Main Results:

• Vancomycin consumption showed a positive correlation with VRE *Enterococcus faecium* (VRE_fm) prevalence.
• Rural population, elderly proportion (≥65), and annual temperature were significantly correlated with VRE_fm prevalence.
• Hospital bed density per capita was inversely correlated with VRE_fm prevalence.

Conclusions:

• Vancomycin utilization is the primary driver of VRE_fm resistance.
• Demographic factors like rural population and age ≥65 have a smaller, yet significant, impact.
• Annual temperature and hospital bed availability act as protective factors against VRE_fm.