Tokars J I, Satake S, Rimland D, Carson L, Miller E R, Killum E, Sinkowitz-Cochran R L, Arduino M J, Tenover F C, Marston B, Jarvis W R
Hospital Infections Program, Centers for Disease Control and Prevention, Veterans' Affairs Medical Center, Atlanta, GA 30333, USA.
Infect Control Hosp Epidemiol. 1999 Mar;20(3):171-5. doi: 10.1086/501606.
To study vancomycin-resistant Enterococcus (VRE) prevalence, risk factors, and clustering among hospital inpatients.
Rectal-swab prevalence culture survey conducted from February 5 to March 22, 1996.
The Veterans' Affairs Medical Center, Atlanta, Georgia.
Hospital (medical and surgical) inpatients.
The overall VRE prevalence was 29% (42/147 patients). The VRE prevalence was 52% (38/73 patients) among patients who had received at least one of six specific antimicrobials during the preceding 120 days, compared with only 5% (4/74) among those who had not received the antimicrobials (relative risk, 9.6; P<.001). The longer the period (up to 120 days) during which antimicrobial use was studied, the more closely VRE status was predicted. Among 67 hospital patients in 28 multibed rooms, clustering of VRE among current roommates was not found.
At this hospital with relatively high VRE prevalence, VRE colonization was related to antibiotic use but not to roommate VRE status. In hospitals with a similar VRE epidemiology, obtaining cultures from roommates of VRE-positive patients may not be as efficient a strategy for identifying VRE-colonized patients as obtaining screening cultures from patients who have received antimicrobials.
研究耐万古霉素肠球菌（VRE）在医院住院患者中的流行情况、危险因素及聚集性。
1996年2月5日至3月22日进行的直肠拭子流行率培养调查。
佐治亚州亚特兰大市退伍军人事务医疗中心。
医院（内科和外科）住院患者。
VRE总体流行率为29%（42/147例患者）。在前120天内接受过六种特定抗菌药物中至少一种的患者中，VRE流行率为52%（38/73例患者），而未接受抗菌药物的患者中仅为5%（4/74）（相对风险为9.6；P<0.001）。研究抗菌药物使用的时间越长（最长120天），VRE状态的预测就越准确。在28间多床位病房的67名医院患者中，未发现VRE在当前室友中聚集。
在这家VRE流行率相对较高的医院，VRE定植与抗生素使用有关，但与室友的VRE状态无关。在VRE流行病学情况相似的医院，从VRE阳性患者室友处获取培养物可能不像从接受过抗菌药物治疗的患者中获取筛查培养物那样是一种有效的识别VRE定植患者的策略。
