Independent risk factors for the co-colonization of vancomycin-resistant Enterococcus faecalis and methicillin-resistant Staphylococcus aureus in the region most endemic for vancomycin-resistant Staphylococcus aureus isolation

Hayakawa, Kayoko; Marchaim, Dror; Bathina, Pradeep; Martin, Emily T.; Pogue, Jason M.; Sunkara, Bharath; Kamatam, Srinivasa; Ho, Kevin; Willis, Louise; Ajamoughli, Mayan; Patel, Dhiren; Khan, Amber; Lee, K. P.; Suhrawardy, U.; Jagadeesh, K; Reddy, Sagar Mallikethi Lepakshi; Levine, Miriam; Ahmed, Farah; Omotola, A. M.; Mustapha, Muhammad; Moshos, Judy; Rybak, Michael J.; Kaye, Keith S.

doi:10.1007/s10096-013-1814-z

Cited by 16 publications

(16 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The percentage of colonization by MRSA (6 %) upon admission or during ICU stay was low compared to the rates from international ICU departments [15]. The most plausible explanation for this low percentage may be attributed to prior implementation of a [16,17], this is the first study showing that enteric colonization by VRE predisposes to MRSA colonization upon ICU admission and during stay. A meta-analysis investigating risk factors for MRSA colonization upon hospital or ICU admission showed that VRE carriage increased the risk for MRSA by 3.12 times [18].…”

Section: Discussionmentioning

confidence: 77%

Co-colonization by multidrug-resistant bacteria in two Greek intensive care units

Papadimitriou-Olivgeris

Spiliopoulou

Christofidou

et al. 2015

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

Our goal was to identify the risk factors for co-colonization by KPC-producing Klebsiella pneumoniae (KPC-Kp), vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) upon intensive care unit (ICU) admission and during stay. Rectal and nasal samples were taken from each patient upon admission at two Greek ICUs and each week afterwards, and were inoculated onto chromogenic agar. Representative colonies were characterized with standard methods and Vitek-2 technology. The presence of the bla KPC gene (K. pneumoniae isolates), vanA and vanB (Enterococcus faecium and E. faecalis isolates), and mecA (S. aureus isolates) was confirmed by polymerase chain reaction (PCR). Upon ICU admission, among 481 patients, 59 (12%), 63 (13%), and 20 (4%) were colonized by KPC-Kp, VRE, or MRSA, respectively. Simultaneous colonization by KPC-Kp and VRE upon admission (34 patients) was associated with the number of co-morbidities [adjusted odds ratio (aOR): 1.5; confidence interval (CI) 1.0-2.5], administered antibiotics (aOR: 1.7; CI 1.3-2.3), and prior KPC-Kp infection (aOR: 24.4; CI 1.5-396.0). Among patients with an ICU stay of more than 6 days, 181 (73%), 31 (13%), and 9 (4%) became KPC-Kp, VRE, or MRSA colonized during ICU stay, respectively. KPC-Kp colonization was an independent risk factor for VRE colonization upon admission (aOR: 2.7; CI 1.0-7.2) and during stay (aOR: 7.4; CI 2.0-27.4), whereas VRE colonization was a risk factor for KPC-Kp upon admission (aOR: 5.1; CI 1.9-13.9) and MRSA colonization upon admission (aOR: 3.5; CI 1.2-10.1) and during ICU stay (aOR: 14.5; CI 2.1-100.1). Colonization by a multidrug pathogen could promote colonization by another.

show abstract

Section: Discussionmentioning

confidence: 77%

Co-colonization by multidrug-resistant bacteria in two Greek intensive care units

Papadimitriou-Olivgeris

Spiliopoulou

Christofidou

et al. 2015

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

show abstract

“…Indeed, in our study, patients with VR E. faecalis were frequently cocolonized with MRSA to a greater degree than patients with VS E. faecalis and uninfected controls. Furthermore, our team recently reported that the severity of illness, presence of indwelling devices, and chronic wounds are independent predictors for cocolonization with VR E. faecalis and MRSA (20). These findings, together with the growing prevalence of VR E. faecalis and the relatively high prevalence of Inc18-like plasmids in Michigan, might partially explain the endemicity of VRSA in this region (3,8).…”

Section: Discussionmentioning

confidence: 86%

Epidemiology of Vancomycin-Resistant Enterococcus faecalis: a Case-Case-Control Study

Hayakawa

Marchaim

Palla

et al. 2013

Antimicrob Agents Chemother

View full text Add to dashboard Cite

e Although much is known about vancomycin-resistant (VR) Enterococcus faecium, little is known about the epidemiology of VR Enterococcus faecalis. The predilection of VR E. faecalis to transfer the vancomycin resistance determinant to Staphylococcus aureus is much greater than that of VR E. faecium. The epidemiology of VR E. faecalis has important implications regarding the emergence of vancomycin-resistant S. aureus (VRSA); 8 of 13 reported VRSA cases have been from Michigan. A retrospective case-case-control study was conducted at the Detroit Medical Center, located in southeastern Michigan. Unique patients with VR E. faecalis infection were matched to patients with strains of vancomycin-susceptible (VS) E. faecalis and to uninfected controls at a 1:1:1 ratio. Five hundred thirty-two VR E. faecalis cases were identified and were matched to 532 VS E. faecalis cases and 532 uninfected controls. The overall mean age of the study cohort (n ‫؍‬ 1,596) was 63.0 ؎ 17.4 years, and 747 (46.8%) individuals were male. Independent predictors for the isolation of VR E. faecalis (but not VS E. faecalis) compared to uninfected controls were an age of >65 years, nonhome residence, diabetes mellitus, peripheral vascular disease, exposure to cephalosporins and fluoroquinolones in the prior 3 months, and immunosuppressive status. Invasive procedures and/or surgery, chronic skin ulcers, and indwelling devices were risk factors for both VR E. faecalis and VS E. faecalis isolation. Cephalosporin and fluoroquinolone exposures were unique, independent predictors for isolation of VR E. faecalis. A majority of case patients had VR E. faecalis present at the time of admission. Control of VR E. faecalis, and ultimately VRSA, will likely require regional efforts focusing on infection prevention and antimicrobial stewardship.

show abstract

“…Additionally, observational studies have found an increased risk of cocolonization by resistant gastrointestinal bacteria when a patient is already colonized by bacteria resistant to different classes of antibiotics, possibly indicating that resistant bacterial strains are less likely to be competitively excluded by each other than by susceptible strains. Such a risk of cocolonization was found independently of other risk factors such as antibiotic usage and patient comorbidities (60,61). Finally, experimental results suggest that patients receiving fecal microbiota transplant of susceptible bacteria are less likely to be recolonized by resistant bacteria (62).…”

Section: Discussionmentioning

confidence: 92%

Vaccination can drive an increase in frequencies of antibiotic resistance among nonvaccine serotypes ofStreptococcus pneumoniae

Obolski

Lourenço

Thompson

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

The bacterial pathogen is a major public health concern, being responsible for more than 1.5 million deaths annually through pneumonia, meningitis, and septicemia. Available vaccines target only a subset of serotypes, so vaccination is often accompanied by a rise in the frequency of nonvaccine serotypes. Epidemiological studies suggest that such a change in serotype frequencies is often coupled with an increase of antibiotic resistance among nonvaccine serotypes. Building on previous multilocus models for bacterial pathogen population structure, we have developed a theoretical framework incorporating variation of serotype and antibiotic resistance to examine how their associations may be affected by vaccination. Using this framework, we find that vaccination can result in a rapid increase in the frequency of preexisting resistant variants of nonvaccine serotypes due to the removal of competition from vaccine serotypes.

show abstract

Independent risk factors for the co-colonization of vancomycin-resistant Enterococcus faecalis and methicillin-resistant Staphylococcus aureus in the region most endemic for vancomycin-resistant Staphylococcus aureus isolation

Cited by 16 publications

References 19 publications

Co-colonization by multidrug-resistant bacteria in two Greek intensive care units

Co-colonization by multidrug-resistant bacteria in two Greek intensive care units

Epidemiology of Vancomycin-Resistant Enterococcus faecalis: a Case-Case-Control Study

Vaccination can drive an increase in frequencies of antibiotic resistance among nonvaccine serotypes ofStreptococcus pneumoniae

Contact Info

Product

Resources

About