Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study
Background: Vancomycin-resistant enterococci (VRE) are prevalent infectious agents that particularly affect critically-ill patients, and they are on the rise in Lebanon. We aim at determining the potential risk factors and complications for VRE and vancomycin-susceptible enterococci (VSE) infections...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123000643 |
| _version_ | 1797850899508363264 |
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| author | Jim Abi Frem Marwan Ghanem George Doumat Zeina A. Kanafani |
| author_facet | Jim Abi Frem Marwan Ghanem George Doumat Zeina A. Kanafani |
| author_sort | Jim Abi Frem |
| collection | DOAJ |
| description | Background: Vancomycin-resistant enterococci (VRE) are prevalent infectious agents that particularly affect critically-ill patients, and they are on the rise in Lebanon. We aim at determining the potential risk factors and complications for VRE and vancomycin-susceptible enterococci (VSE) infections in a hospital setting and identify risk factors for in-hospital mortality. Methods: A case-case-control study design was used where patients with VRE and VSE were included as two separate groups and each group was compared to uninfected controls. We also constructed binary regression models to detect risk factors that were associated with the acquisition of a VRE or a VSE infection. We also identified independent mortality predictors for all patients with enterococcal infection as well as patients with only a VRE infection. Results: A total of 142 patients with enterococcal infections (VRE and VSE) were compared to 142 in-patients not infected with Enterococcus spp. independent risk factors for a VRE infection were steroid therapy within 30 days and the presence of another infection preceding the VRE infection (aOR 15.4, 95 % CI 2.4–99.3 and 23.9, 95 % CI 3.9–1482, respectively). An independent risk factor for VSE was diabetes mellitus (aOR 5.4, 95 % CI 1.1–26.6). Based on these risk factors, we developed a risk score to be used in quantifying the risk of VRE in a patient with an enterococcal infection. Male sex and low albumin were significant risk factors for mortality in our patient cohort. Conclusions: VRE and VSE infections have distinct risk factors that can be used to guide empiric antimicrobial therapy. |
| first_indexed | 2024-04-09T19:09:07Z |
| format | Article |
| id | doaj.art-5ae789aa6c2f4168b4466ee3c7798c20 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-04-09T19:09:07Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-5ae789aa6c2f4168b4466ee3c7798c202023-04-07T06:49:00ZengElsevierJournal of Infection and Public Health1876-03412023-05-01165741745Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control studyJim Abi Frem0Marwan Ghanem1George Doumat2Zeina A. Kanafani3Brighton and Sussex University Hospitals, Brighton, United KingdomAmerican University of Beirut, Beirut, LebanonAmerican University of Beirut, Beirut, LebanonAmerican University of Beirut, Beirut, Lebanon; Correspondence to: American University of Beirut Medical Center, Cairo Street, PO Box 11–0236/11D, Riad El Solh, 1107 2020 Beirut, Lebanon.Background: Vancomycin-resistant enterococci (VRE) are prevalent infectious agents that particularly affect critically-ill patients, and they are on the rise in Lebanon. We aim at determining the potential risk factors and complications for VRE and vancomycin-susceptible enterococci (VSE) infections in a hospital setting and identify risk factors for in-hospital mortality. Methods: A case-case-control study design was used where patients with VRE and VSE were included as two separate groups and each group was compared to uninfected controls. We also constructed binary regression models to detect risk factors that were associated with the acquisition of a VRE or a VSE infection. We also identified independent mortality predictors for all patients with enterococcal infection as well as patients with only a VRE infection. Results: A total of 142 patients with enterococcal infections (VRE and VSE) were compared to 142 in-patients not infected with Enterococcus spp. independent risk factors for a VRE infection were steroid therapy within 30 days and the presence of another infection preceding the VRE infection (aOR 15.4, 95 % CI 2.4–99.3 and 23.9, 95 % CI 3.9–1482, respectively). An independent risk factor for VSE was diabetes mellitus (aOR 5.4, 95 % CI 1.1–26.6). Based on these risk factors, we developed a risk score to be used in quantifying the risk of VRE in a patient with an enterococcal infection. Male sex and low albumin were significant risk factors for mortality in our patient cohort. Conclusions: VRE and VSE infections have distinct risk factors that can be used to guide empiric antimicrobial therapy.http://www.sciencedirect.com/science/article/pii/S1876034123000643EnterococcusVancomycin-resistanceAntimicrobial-resistant organismsSurveillanceMortalityMorbidity |
| spellingShingle | Jim Abi Frem Marwan Ghanem George Doumat Zeina A. Kanafani Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study Journal of Infection and Public Health Enterococcus Vancomycin-resistance Antimicrobial-resistant organisms Surveillance Mortality Morbidity |
| title | Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study |
| title_full | Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study |
| title_fullStr | Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study |
| title_full_unstemmed | Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study |
| title_short | Clinical manifestations, characteristics, and outcome of infections caused by vancomycin-resistant enterococci at a tertiary care center in Lebanon: A case-case-control study |
| title_sort | clinical manifestations characteristics and outcome of infections caused by vancomycin resistant enterococci at a tertiary care center in lebanon a case case control study |
| topic | Enterococcus Vancomycin-resistance Antimicrobial-resistant organisms Surveillance Mortality Morbidity |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123000643 |
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