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Outbreak of ampicillin‐resistant Enterococcus faecium – risk factors for faecal colonisation
Author(s) -
Mohn S.C,
Harthug S.,
Langeland N.
Publication year - 2000
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1034/j.1600-0463.2000.d01-60.x
Subject(s) - colonisation , ampicillin , carriage , medicine , antibiotics , enterococcus faecium , antimicrobial , outbreak , risk factor , enterococcus , microbiology and biotechnology , biology , colonization , virology , pathology
Since January 1995 there has been a nosocomial outbreak at Haukeland University Hospital involving more than 330 patients with clinical infections caused by ampicillin‐resistant Enterococcus faecium (ARE) (minimum inhibitory concentration ≥32 mg/l). Rectal carriage of ARE was initially observed on two medical wards only. Here the ARE colonisation rate has remained high. To assess risk factors for ARE colonisation we performed a case‐control study including 37 rectal carriers of ARE and 83 non‐carriers on these wards. Significant differences were found between cases and controls with respect to the mean number of days on antimicrobial treatment (13.3 for carriers, 5.5 for non‐carriers, p<0.001), mean number of different antibiotics prescribed (2.8 for carriers, 2.1 for non‐carriers, p=0.008) and mean number of days in hospital (18.4 vs 10.2, p=0.001). Unadjusted statistical analysis showed that several antibiotics were risk factors for ARE carriage. Logistic regression analysis showed that fluoroquinolone prescription (OR=3.5, p=0.01) and more than 10 days of antibiotic use (OR=3.3, p=0.01) were significant risk factors. An additional follow‐up screening of previous carriers revealed no colonisation 8 to 36 (median 9) months after discharge from hospital (n=17). Prolonged antimicrobial therapy and broad‐spectrum antibiotics seem to facilitate nosocomial ARE colonisation.