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Factors Associated With Acquisition of Vancomycin-Resistant Enterococci (VRE) in Roommate Contacts of Patients Colonized or Infected with VRE in a Tertiary Care Hospital

Published online by Cambridge University Press:  02 January 2015

Qian Zhou ,
Christine Moore ,
Sarah Eden ,
Agnes Tong ,
Allison McGeer  and
Mount Sinai Hospital Infection Control Team
Qian Zhou
Affiliation:
Department of Public Health Sciences, University of Toronto, Canada
Christine Moore
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Sarah Eden
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Agnes Tong
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Allison McGeer*
Affiliation:
Department of Public Health Sciences, University of Toronto, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
*
Room 210, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G 1X5, (amcgeer@ mtsinai.on.ca)
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Abstract

Objective.

Most nosocomial acquistion of vancomycin-resistant enterococci (VRE) is due to cross-transmission. We sought to identify risk factors for acquisition of VRE by roommates of patients colonized or infected with VRE.

Design.

Retrospective cohort study.

Setting.

A 472-bed tertiary care teaching hospital.

Methods.

All patients who shared a room with a patient colonized or infected with VRE at our hospital between January 1, 1999 and December 31, 2006 were identified. These roommates of VRE-positive patients were screened by rectal swab culture on days 2, 5, and 7 after the last exposure to the index patient. Chart reviews were performed to identify risk factors for VRE colonization in these roommates.

Results.

Eighty-eight roommates of patients colonized or infected with VRE were identified. Of the 38 roommates with complete follow-up, 8 (21%) became colonized with VRE. These 8 roommates were older (median, 87.5 vs 62.5 years of age; P = .001), had longer duration of room exposure (median, 8.5 vs 4 days; P = .002), and were more likely to have a urinary catheter (odds ratio [OR], 16 [95% confidence interval {CI}, 1.7-152]; P = .005), an elevated serum creatinine level (OR, 17 [95% CI, 1.4-196]; P = .02), low serum albumin level (OR, 9.9 [95% CI, 1.3-113]; P = .01), and recent third-generation cephalosporin use (OR, 8.3 [95% CI, 1.5-47]; P = .02).

Conclusion.

Roommates of patients identified as colonized or infected with VRE are at substantial risk of becoming colonized, with the degree of risk increasing in older and more frail patients. VRE control programs should pay particular attention to such patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 5 , May 2008 , pp. 398 - 403
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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