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Related Experiment Videos

Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection

M B Edmond1, J F Ober, D L Weinbaum

  • 1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 1, 1995
PubMed
Summary

An outbreak of vancomycin-resistant Enterococcus faecium (VRE) bacteremia occurred in an oncology ward. Gastrointestinal colonization and broad-spectrum antibiotic use were identified as key risk factors, highlighting the need for prevention strategies.

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Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Antimicrobial Resistance

Background:

  • Vancomycin-resistant Enterococcus faecium (VRE) poses a significant threat in healthcare settings.
  • Oncology patients, particularly those with leukemia and neutropenia, are highly vulnerable to severe infections.

Purpose of the Study:

  • To investigate an outbreak of VRE bacteremia on an oncology ward.
  • To identify risk factors associated with VRE bacteremia in this patient population.
  • To inform prevention and control strategies for VRE infections.

Main Methods:

  • Retrospective case-control study comparing VRE bacteremia cases with matched controls.
  • Molecular typing (e.g., PFGE) to assess strain relatedness and identify nosocomial spread.

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  • Analysis of patient demographics, clinical characteristics, and antibiotic exposure.

    • Main Results:

    • Eleven cases of VRE bacteremia were identified, primarily in neutropenic leukemia patients (10/11).
    • A common VRE strain accounted for 83% of isolates, suggesting nosocomial transmission.
    • Significant risk factors included gastrointestinal colonization with VRE and prior use of broad-spectrum antibiotics active against anaerobes (metronidazole, clindamycin, imipenem).
    • High mortality rate of 73% observed among patients with VRE bacteremia.

    Conclusions:

    • The study highlights a VRE outbreak on an oncology ward with a high mortality rate.
    • Gastrointestinal colonization and specific antibiotic exposures are critical risk factors.
    • Urgent need for effective prevention and control measures to combat VRE bacteremia in vulnerable patient groups.