Background. An increased risk of vancomycin resistant Enterococcus spp. (VRE) colonization, usually progressing into infection in patients with immunosuppression, hematological malignancies, organ transplantation, increased intensive care unit or hospital stay, infection of an additional body side.
The aim of our study was to investigate other risk factors for VRE infection development.
Material and methods. For all study patients the following characteristics were recorded: demographic data, source of infection, the patient ward at the time of infection, days of mechanical ventilation before and after Enterococcus spp. infection, days of hospital and intensive care unit (ICU) stay post infection, antimicrobial agents administered during hospitalization before Enterococcus spp. infection developed. The cases were assigned as vancomycin resistant Enterococcus spp. (VRE) cases if they had VRE infection and as vancomycin sensitive Enterococcus spp. (VSE) cases if they had VSE Enterococcus spp. infections.
Results. E. faecium were more resistant to tested antibiotics in comparison with E. faecalis strains. Resistance to vancomycin varied depending on the origin of the source of infection. For patients treated in ICU prior to infection E. faecium was found more often in comparison to E. faecalis. Univariate analysis revealed that hospitalization in intensive care unit (ICU) prior to infection was a risk factor for VRE infection development. Prior use of antimicrobials was a risk factor for selection of VRE. Only 2 (7.7%) cases of VSE and even 11 (47.8%) cases of VRE were found in carbapenem treatment group (P=0.002), 1 (3.8%) of VSE and 6 (26.1%) of VRE cases in quinolones treatment group (P=0.033) and 2 (7.7%) of VSE and 11 (47.8%) of VRE in vancomycin treatment group (P=0.002).
Conclusions. We found that VRE were isolated from urine more often, especially in patients with abnormal renal function: creatinine and urea concentrations were high. Prior use of vancomycin was a risk factor for VRE infection development: it means that the dose regimen and pharmacokinetics of vancomycin not always was considered, especially for patients with severely impaired renal function.
