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Title: Comparative epidemiology of vancomycin-resistant enterococci colonization in an acute-care hospital and its affiliated intermediate- and long-term care facilities in Singapore
Authors: Tan, Damon
Htun, Htet Lin
Koh, Jocelyn
Kanagasabai, Kala
Lim, Jia-Wei
Hon, Pei-Yun
Ang, Brenda
Chow, Angela
Keywords: DRNTU::Science::Medicine
Vancomycin-resistant Enterococci
Issue Date: 2018
Source: Tan, D., Htun, H. L., Koh, J., Kanagasabai, K., Lim, J.-W., Hon, P.-Y., . . . Chow, A. (2018). Comparative epidemiology of vancomycin-resistant enterococci colonization in an acute-care hospital and its affiliated intermediate- and long-term care facilities in Singapore. Antimicrobial Agents and Chemotherapy, 62(12), e01507-18-. doi: 10.1128/AAC.01507-18
Series/Report no.: Antimicrobial Agents and Chemotherapy
Abstract: Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infections in acute-care hospitals (ACHs), intermediate-care facilities (ITCFs), and long-term care facilities (LTCFs). This study contemporaneously compared the epidemiology and risk factors for VRE colonization in different care settings in a health care network. We conducted a serial cross-sectional study in a 1,700-bed ACH and its six closely affiliated ITCFs and LTCFs in June and July of 2014 to 2016. Rectal swab or stool specimens were cultured for VRE. Multivariable logistic regression was used to assess for independent risk factors associated with VRE colonization. Of 5,357 participants, 523 (9.8%) were VRE colonized. VRE prevalence was higher in ACHs (14.2%) than in ITCFs (7.6%) and LTCFs (0.8%). Common risk factors between ACHs and ITCFs included prior VRE carriage, a longer duration of antibiotic therapy, surgery in the preceding 90 days, and the presence of a skin ulcer. Independent risk factors specific to ACH-admitted patients were prior methicillin-resistant Staphylococcus aureus carriage, a higher number of beds per room, prior proton pump inhibitor use, and a length of stay of >14 days. For ITCFs, a length of stay of >14 days was inversely associated with VRE colonization. Similarities and differences in risk factors for VRE colonization were observed between health care settings. VRE prevention efforts should target the respective high-risk patients.
ISSN: 0066-4804
DOI: 10.1128/AAC.01507-18
Rights: ©2018 American Society for Microbiology. This paper was published in Antimicrobial Agents and Chemotherapy and is made available as an electronic reprint (preprint) with permission of American Society for Microbiology. The published version is available at: []. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper is prohibited and is subject to penalties under law.
Fulltext Permission: open
Fulltext Availability: With Fulltext
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