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Byun and Kang: Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2013; 43(2): 287-295.

Published online: 30 April 2013

DOI: https://doi.org/10.4040/jkan.2013.43.2.287

Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission

Sook-Jin Byun1, Jiyeon Kang2

1Infection Control Team, Dong-A University Medical Center, Busan, Korea.

2Department of Nursing, Dong-A University, Busan, Korea.

Address reprint requests to: Kang, Jiyeon. Department of Nursing, Dong-A University, 1 Dongdaesin-dong, 3-ga, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2871, Fax: +82-51-240-2920, jykang@dau.ac.kr

Received 27 September 2012       Accepted 24 January 2013

© 2013 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization.

Methods

Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method.

Results

During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality.

Conclusion

Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

Keywords: Vancomycin resistance, Enterococcus, Infection control, Intensive care units

Figures and Tables

Table 1
Characteristics of Study Patients
jkan-43-287-i001

ICU=Intensive care unit; COPD=Chronic obstructive pulmonary disease.

*After propensity score matching (N =398)

Table 2
Factors Influencing VRE Colonization
jkan-43-287-i002

MRSA=Methicillin resistant staphylococcus aureus.

Table 3
Multivariate Analysis of Risk Factors for VRE Colonization
jkan-43-287-i003

OR=Odds ratio; 95% CI=5% confidence interval to OR; MRSA=Methicillin resistant staphylococcus aureus.

Table 4
Comparison of Clinical Outcomes between VRE Colonized and Uncolonized Groups
jkan-43-287-i004

*Multiple checks allowed; ICU=Intensive care unit.

Notes

This manuscript is a revision of the first author's master's thesis from Dong-A University.

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