Bui Minh Trang, Rohde Anna M, Schwab Frank, Märtin Nayana, Kipnis Marina, Boldt Anne-Cathérine, Behnke Michael, Denkel Luisa A, Kola Axel, Zweigner Janine, Gastmeier Petra, Wiese-Posselt Miriam
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Hygiene and Environmental Medicine, Berlin, Germany.
German Center for Infection Research (DZIF), Braunschweig, Germany.
GMS Hyg Infect Control. 2021 Jan 29;16:Doc06. doi: 10.3205/dgkh000377. eCollection 2021.
Hospital-acquired infections due to vancomycin-resistant enterococci (VRE) are emerging globally. The aims of our study were to estimate VRE colonisation prevalence in patients upon admission, to determine possible risk factors for VR acquisition that already exist in the outpatient setting, and to monitor whether VRE-colonised patients developed a VRE infection during their current hospital stay. In 2014 and 2015, patients admitted to non-intensive care units were screened for rectal VRE carriage. The study patients filled out a questionnaire on potential risk factors. Analyses were restricted to VR carriage. All patients with VRE colonisation were retrospectively monitored for infections with VRE during their current hospital stay. In 4,013 enrolled patients, the VRE colonisation prevalence upon admission was 1.2% (n=48), and colonisation prevalence was 1.1% (n=45) for VR . Only one VRE-colonised patient developed an infection with the detection of a VRE, among others. Colonisation with VR was associated with current antibiotic use. Risk factors of VR colonisation upon admission were increasing age, previous colonisation or infection with multidrug resistant organisms, sampling year 2015, and, within the previous six months, antibiotic exposure, a stay at a rehabilitation center, and a hospital stay. We observed that antibiotic treatment which occurred prior admission influenced VR prevalence upon admission. Thus, wise antibiotic use in outpatient settings plays a major role in the prevention of VR acquisition.
耐万古霉素肠球菌（VRE）引起的医院获得性感染正在全球范围内出现。我们研究的目的是估计患者入院时VRE定植的患病率，确定门诊环境中已存在的VRE感染的可能危险因素，并监测VRE定植患者在当前住院期间是否发生VRE感染。2014年和2015年，对入住非重症监护病房的患者进行了直肠VRE携带情况筛查。研究患者填写了一份关于潜在危险因素的问卷。分析仅限于VR携带情况。对所有VRE定植患者进行回顾性监测，以观察其在当前住院期间是否发生VRE感染。在4013名登记患者中，入院时VRE定植患病率为1.2%（n = 48），VR定植患病率为1.1%（n = 45）。在检测出VRE的患者中，只有一名VRE定植患者发生了感染。VR定植与当前使用抗生素有关。入院时VR定植的危险因素包括年龄增加、既往定植或感染多重耐药菌、2015年采样年份以及在前六个月内使用抗生素、在康复中心停留和住院。我们观察到入院前的抗生素治疗会影响入院时VR的患病率。因此，门诊环境中明智地使用抗生素在预防VR感染方面起着重要作用。
