Influence of Glycopeptides, as a Risk Factor on Intestinal Colonization with Vancomycin-Resistant Enterococcus

Shin, Jeong Hwan; Chang, Chul Hun; Son, Han Chul; Park, Kwang Ok

Abstract

BACKGROUND: Several risk factors related with vancomycin-resistant Enterococcus (VRE) colonization are well known, but the direct relatedness of the use of glycopeptides with VRE colonization is not confirmed yet. So we evaluated the influence of the use of glycopeptides and other variables, as risk factors on intestinal colonization with VRE.
METHODS
In glycopeptide-administered inpatients group, multiple stool specimens were collected on the day of glycopeptides administration, and weekly after that, until VRE were detected. In the inpatients and outpatients control groups, stool were obtained with point survey. The specimens were inoculated on m-enterococcus agar with 6mg/L vancomycin. The phenotypes and genotypes of resistance of the VRE isolates were confirmed by disk diffusion and agar dilution tests, and polymerase chain reaction.
RESULTS
Of the 361 patients(530 specimens), twelve VRE(3.3%) were isolated. The rates of intestinal colonizations were not significantly differed between the inpatients groups with or without glycopeptides administration, which are 5.1 and 4.1%, respectively. The colonization rates were significantly higher in the patients with 30 or more hospital stay, and in those with three or more antimicrobial administrations. vanA and vanC genes were amplified in the isolates.
CONCLUSIONS
It is demonstrated that the use of glycopeptides is not a direct risk factor of intestinal colonization of VRE in Pusan National University Hospital, in which the prescription of glycopeptides is rigidly controlled. But, a shortened stay in the hospital will diminish the intestinal colonization of VRE.