Screening for Intestinal Colonization with Vancomycin Resistant Enterococci and Associated Risk Factors among Patients Admitted to an Adult Intensive Care Unit of a Large Teaching Hospital
Introduction: Gut colonization with Vancomycin Resistant Enterococci (VRE) increases the risk of acquiring infection during hospital stay. Patients admitted in the ICU’s are the major reservoirs for VRE colonization due to higher antibiotic pressure. Aim: To determine the rate of VRE colonizati...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8418/20562_CE[Ra]_F(P)_PF1(AHESAK)_PFA(AK).pdf |
| Summary: | Introduction: Gut colonization with Vancomycin Resistant
Enterococci (VRE) increases the risk of acquiring infection
during hospital stay. Patients admitted in the ICU’s are the
major reservoirs for VRE colonization due to higher antibiotic
pressure.
Aim: To determine the rate of VRE colonization among patients
admitted in the Medical Intensive Care Unit (MICU) and to
assess the various risk factors which are associated with VRE
colonization.
Materials and Methods: This was a prospective study carried
out over a period of 18 months from September 2013 to February
2015 in the Jawaharlal Institute of Post graduate Medical
Education and Research (JIPMER), Pondicherry, South India.
After 48 hours of ICU admission rectal swabs were collected
from a total of 302 patients, admitted in MICU. The samples
were inoculated on to Bile Esculin Sodium Azide agar with
6mg/L of vancomycin. Vancomycin resistance was confirmed
by determination of Minimum Inhibitory Concentration (MIC)
by agar dilution method. Isolates were identified up to species
level by standard biochemical tests. Vancomycin resistance
genes such as van A, van B and van C, were detected by
Polymerase Chain Reaction (PCR). Risk factors were assessed
by multivariate logistic regression analysis.
Results: The rates of VRE colonization in patients admitted
to MICU was 29%. Majority of the isolates were Enterococcus
faecium (77.2 %) followed by Enterococcus faecalis (23.8%). All
the VRE isolates were positive for van A gene. Increased duration
of hospital stay, younger age, consumption of ceftriaxone and
vancomycin were found to be significantly associated with VRE
colonization in MICU. Among VRE colonized patients, six (4.5%)
acquired VRE infection.
Conclusion: The rates of VRE colonization in our ICU were
similar to other hospitals worldwide. Educating health care
workers on the importance of adherence to hand hygiene is
essential to bring down VRE colonization rates. |
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| ISSN: | 2249-782X 0973-709X |