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 |
| _version_ | 1818752242088411136 |
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| author | Rajesh Amberpet Sujatha Sistla Subhash Chandra Parija Molly Mary Thabah |
| author_facet | Rajesh Amberpet Sujatha Sistla Subhash Chandra Parija Molly Mary Thabah |
| author_sort | Rajesh Amberpet |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-18T04:48:21Z |
| format | Article |
| id | doaj.art-cc5e72cf2ad4447eb930d1c07414e69e |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-18T04:48:21Z |
| publishDate | 2016-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-cc5e72cf2ad4447eb930d1c07414e69e2022-12-21T21:20:31ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-09-01109DC06DC0910.7860/JCDR/2016/20562.8418Screening for Intestinal Colonization with Vancomycin Resistant Enterococci and Associated Risk Factors among Patients Admitted to an Adult Intensive Care Unit of a Large Teaching HospitalRajesh Amberpet0Sujatha Sistla1Subhash Chandra Parija2Molly Mary Thabah3PhD Scholar, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.Professor and Head, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.Director and Senior Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.Associate Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.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.https://jcdr.net/articles/PDF/8418/20562_CE[Ra]_F(P)_PF1(AHESAK)_PFA(AK).pdficuvancomycin resistant enterococcivrevan a |
| spellingShingle | Rajesh Amberpet Sujatha Sistla Subhash Chandra Parija Molly Mary Thabah 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 Journal of Clinical and Diagnostic Research icu vancomycin resistant enterococci vre van a |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | icu vancomycin resistant enterococci vre van a |
| url | https://jcdr.net/articles/PDF/8418/20562_CE[Ra]_F(P)_PF1(AHESAK)_PFA(AK).pdf |
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