Abstract
BackgroundIn the context of an aging population, identifying risk factors for Vancomycin-resistant enterococci (VRE), specific to older people, is important. However, if age is a known risk factor for VRE infection, a limited number of studies have focused on older patients. This study aimed to identify potential risk factors for VRE acquisition in a population aged 65 years and older, during a large VRE outbreak that occurred in a teaching hospital in Lyon, France, from December 2013 to July 2014.MethodsThe present retrospective, multi-center, descriptive, and analytical study used part of a previous cohort, and included only a sub-group of patients aged 65 years and older. The analysis of the factors included in the original study was completed with factors more specific to geriatric patients. Inclusion criteria were patients aged 65 years and older, in contact with a VRE index patient. Patients were screened by rectal swabs. Univariate and multivariate logistic regression analyses were performed.ResultsA total of 180 VRE contacts were included and 18 patients became carriers. Multivariate analysis showed that risk factors for VRE acquisition in older people included major contact type (RR: 5.31, 95%CI [1.33; 21.19]), number of antibiotics used (RR: 1.36, 95%CI [1.04; 1.76]), a score of McCabe = 2 (RR: 116.39, 95%CI [5.52; 2455.98]), ethylism (RR: 5.50, 95%CI [1.49; 20.25]), and dementia (RR: 7.50, 95%CI [1.89; 29.80]).ConclusionsThis study was able to demonstrate risk factors for VRE acquisition in older people. These risk factors should be taken into account when in the presence of older people in a VRE infected unit.
Highlights
In the context of an aging population, identifying risk factors for Vancomycin-resistant enterococci (VRE), specific to older people, is important
Based on the work provided by Djembi et al, the present study focused on identifying risk factors for VRE acquisition, during the initial period of the outbreak (December 2013 to February 2014), in a population of patients aged 65 years and older from the teaching hospitals in Lyon, France
Univariate analysis revealed that significant risk factors associated with becoming a carrier patient included male sex, major contact, hospitalization in geriatric rehabilitation unit, antibiotics use, glycopeptides use, use of 3 antibiotics or more, different antibiotics number, a McCabe score equal to 2, ethylism, dementia, bedsore, albumin rate, and c-reactive protein (CRP) rate (Tables 1 and 2)
Summary
In the context of an aging population, identifying risk factors for Vancomycin-resistant enterococci (VRE), specific to older people, is important. If age is a known risk factor for VRE infection, a limited number of studies have focused on older patients. This study aimed to identify potential risk factors for VRE acquisition in a population aged 65 years and older, during a large VRE outbreak that occurred in a teaching hospital in Lyon, France, from December 2013 to July 2014. In France, between July 2001 and June 2015, 1140 cases of nosocomial infections involving VRE were reported [1]. A large VRE outbreak occurred at a teaching hospital in Lyon, France, from December 2013 to July 2014. The index case was identified on December 13, 2013, detected by analysis of the liquid contained in the Kehr
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