Patient- and hospital-level predictors of vancomycin-resistant Enterococcus (VRE) bacteremia in Ontario, Canada Academic Article uri icon

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abstract

  • BACKGROUND: Data are limited on risk factors for vancomycin-resistant Enterococcus (VRE) bacteremia. METHODS: All patients with a confirmed VRE bacteremia in Ontario, Canada, between January 2009 and December 2013 were linked to provincial healthcare administrative data sources and frequency matched to 3 controls based on age, sex, and aggregated diagnosis group. Associations between predictors and VRE bacteremia were estimated by generalized estimating equations and summarized using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). RESULTS: In total, 217 cases and 651 controls were examined. In adjusted analyses, patient-level predictors included bone marrow transplant (OR 106.99 [95% CI 12.19-939.26]); solid organ transplant (OR 17.17 [95% CI 4.95-59.54]); any cancer (OR 8.64 [95% CI 3.88-19.21]); intensive care unit (ICU) admission (OR 6.81 [95% CI 3.53-13.13]); heart disease (OR 5.27 [95% CI 2.00-13.90]); and longer length of stay (OR 1.07 per day [95% CI 1.06-1.09]). Hospital-level predictors included hospital size (per increase in 100 beds (OR 1.26 [95% CI 1.07-1.48]) and teaching hospitals (OR 3.87 [95% CI 1.85-8.08]). CONCLUSIONS: Patients with a bone marrow transplant, solid organ transplant, cancer, or who are admitted to the ICU are at highest risk of VRE bacteremia, particularly at large hospitals and teaching hospitals.

authors

  • Johnstone, Jennie
  • Chen, Cynthia
  • Rosella, Laura
  • Adomako, Kwaku
  • Policarpio, Michelle E
  • Lam, Freda
  • Prematunge, Chatura
  • Garber, Gary
  • Evans, Gerald A
  • Gardam, Michael
  • Hota, Susy
  • John, Michael
  • Katz, Kevin
  • Lemieux, Camille
  • McGeer, Allison
  • Mertz, Dominik
  • Muller, Matthew P
  • Roth, Virginia
  • Suh, Kathryn N
  • Vearncombe, Mary

publication date

  • November 2018