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Background  Enterococci are a major cause of healthcare-associated infection. In Australia,  vanB  vancomycin-resistant enterococci (VRE) is the predominant genotype. There are limited data on the factors linked to  vanB  VRE bacteraemia. This study aimed to identify factors associated with  vanB  VRE bacteraemia, and compare them with those for vancomycin-susceptible enterococci (VSE) bacteraemia.    Methods  A case-case-control study was performed in two tertiary public hospitals in Victoria, Australia. VRE and VSE bacteraemia cases were compared with controls without evidence of enterococcal bacteraemia, but may have had infections due to other pathogens.    Results  All VRE isolates had  vanB  genotype. Factors associated with  vanB  VRE bacteraemia were urinary catheter use within the last 30 days (OR 2.86, 95% CI 1.09-7.53), an increase in duration of metronidazole therapy (OR 1.65, 95% CI 1.17-2.33), and a higher Chronic Disease Score specific for VRE (OR 1.70, 95% CI 1.05-2.77). Factors linked to VSE bacteraemia were a history of gastrointestinal disease (OR 2.29, 95% CI 1.05-4.99) and an increase in duration of metronidazole therapy (OR 1.23, 95% CI 1.02-1.48). Admission into the haematology/oncology unit was associated with lower odds of VSE bacteraemia (OR 0.08, 95% CI 0.01-0.74).    Conclusions  This is the largest case-case-control study involving  vanB  VRE bacteraemia. Factors associated with the development of  vanB  VRE bacteraemia were different to those of VSE bacteraemia.

Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia