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Related Experiment Videos

Colonization with vancomycin-resistant enterococci in chronic hemodialysis patients

M C Roghmann1, J C Fink, L Polish

  • 1University of Maryland School of Medicine, Baltimore, USA. mroghman@umaryland.edu

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|August 26, 1998
PubMed
Summary

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Vancomycin-resistant enterococcus (VRE) colonization is common in hemodialysis patients, particularly those with recent hospitalizations. However, VRE colonization does not increase mortality risk in these patients.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Epidemiology

Background:

  • Vancomycin-resistant enterococcus (VRE) is increasingly prevalent in dialysis populations.
  • Risk factors for VRE colonization in hemodialysis patients are not well understood.

Purpose of the Study:

  • To identify risk factors for VRE colonization in hemodialysis patients.
  • To determine the association between VRE colonization and mortality or infection in this population.

Main Methods:

  • Prospective surveillance and clinical cultures for VRE were performed on 168 hemodialysis patients.
  • Demographic and clinical data, including comorbidities and hospitalization history, were collected.
  • Patients were followed for mortality, hospitalization, and VRE infection.

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Main Results:

  • Sixteen patients had VRE detected on surveillance cultures, and nine had VRE on clinical cultures.
  • VRE-positive patients had shorter time on hemodialysis before screening and more hospitalizations in the prior year.
  • VRE colonization was associated with a higher risk of VRE infection but not increased all-cause mortality after adjusting for comorbidities.

Conclusions:

  • VRE colonization is linked to recent hospitalization and shorter dialysis vintage, suggesting inpatient transmission.
  • VRE colonization in hemodialysis patients does not independently increase mortality risk.
  • Interventions to prevent VRE transmission in hospitals are crucial for this vulnerable population.