Antecedent Treatment with Different Antibiotic Agents as a Risk Factor for Vancomycin-Resistant Enterococcus
Citation
Carmeli, Yehuda, George M. Eliopoulos, and Matthew H. Samore. 2002. Antecedent treatment with different antibiotic agents as a risk factor for vancomycin-resistant Enterococcus. Emerging Infectious Diseases 8(8): 802-807.Abstract
We conducted a matched case-control study to compare the effect of antecedent treatment with various antibiotics on subsequent isolation of vancomycin-resistant Enterococcus (VRE); 880 in-patients; 233 VRE cases, and 647 matched controls were included. After being matched for hospital location, calendar time, and duration of hospitalization, the following variables predicted VRE positivity: main admitting diagnosis; a coexisting condition (e.g., diabetes mellitus, organ transplant, or hepatobiliary disease); and infection or colonization with methicillin-resistant Staphylococcus aureus or Clostridium difficile within the past year (independent of vancomycin treatment). After controlling for these variables, we examined the effect of various antibiotics. Intravenous treatment with third-generation cephalosporins, metronidazole, and fluoroquinolones was positively associated with VRE. In our institution, when we adjusted the data for temporo-spatial factors, patient characteristics, and hospital events, treatment with third-generation cephalosporins, metronidazole, and fluoroquinolones was identified as a risk factor for VRE. Vancomycin was not a risk factor for isolation of VRE.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732508/pdf/Terms of Use
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