住院患者耐万古霉素粪肠球菌菌血症的危险因素：两项病例对照研究的分析

Risk factors for vancomycin-resistant Enterococcus faecalis bacteremia in hospitalized patients: an analysis of two case-control studies.

作者信息

Furtado Guilherme Henrique Campos, Mendes Rodrigo Elisandro, Pignatari Antônio Carlos Campos, Wey Sérgio Barsanti, Medeiros Eduardo Alexandrino Servolo

机构信息

Infection Control Committee, Division of Infectious Diseases, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Am J Infect Control. 2006 Sep;34(7):447-51. doi: 10.1016/j.ajic.2005.08.015.

DOI:10.1016/j.ajic.2005.08.015

PMID:16945692

Abstract

BACKGROUND

Vancomycin-resistant enterococci (VRE) is an important pathogen in the hospital environment, and a progressive increase in its incidence is a cause of nosocomial infections. Bacteremia is one of the major infections caused by this pathogen. Risk factors for VRE bacteremia were assessed at a university-affiliated hospital.

METHODS

Two case-control studies with different control groups were used. In study 1, patients with VRE bacteremia were compared with control patients matched by sex, admission unit, age (+/-10 years), and time of admission (+/-1 year). In study 2, the case group (VRE patients) was compared with vancomycin-susceptible enterococci (VSE) patients.

RESULTS

A total of 34 patients with VRE bacteremia and 102 control patients were included in study 1, and 34 patients with VRE bacteremia and 55 patients with VSE bacteremia were included in study 2. In study 1, vancomycin use (OR, 10.19; CI 95%, 3.63-28.57) was associated with VRE bacteremia. In study 2, vancomycin use (OR, 17.58; CI 95%, 5.24-58.96) was also associated with VRE bacteremia.

CONCLUSION

Because vancomycin use was the only variable associated with VRE bacteremia in the two studies, we confirmed that vancomycin exposure is the major risk factor for VRE bacteremia.

摘要

背景

耐万古霉素肠球菌（VRE）是医院环境中的一种重要病原体，其发病率的逐渐上升是医院感染的一个原因。菌血症是由这种病原体引起的主要感染之一。在一家大学附属医院对VRE菌血症的危险因素进行了评估。

方法

采用两项对照组不同的病例对照研究。在研究1中，将VRE菌血症患者与按性别、入院科室、年龄（±10岁）和入院时间（±1年）匹配的对照患者进行比较。在研究2中，将病例组（VRE患者）与万古霉素敏感肠球菌（VSE）患者进行比较。

结果

研究1共纳入34例VRE菌血症患者和102例对照患者，研究2共纳入34例VRE菌血症患者和55例VSE菌血症患者。在研究1中，使用万古霉素（比值比，10.19；95%置信区间，3.63 - 28.57）与VRE菌血症相关。在研究2中，使用万古霉素（比值比，17.58；95%置信区间，5.24 - 58.96）也与VRE菌血症相关。