Vancomycin-resistant enterococci colonization in patients at seven hemodialysis centers

Jerome I. Tokars, Todd Gehr, William R. Jarvis, John Anderson, Nancy Armistead, Elaine R. Miller, Joan Parrish, Sadaf Qaiyumi, Matthew Arduino, Stacey C. Holt, Fred C. Tenover, Glennis Westbrook, Paul Light

Research output: Contribution to journalArticle

Abstract

Background. Vancomycin-resistant enterococci (VRE) are increasing in prevalence at many institutions, and are often reported in dialysis patients. We studied the prevalence of and risk factors for VRE at seven outpatient hemodialysis centers (three in Baltimore, MD, USA, and four in Richmond, VA, USA). Methods. Rectal or stool cultures were performed on consenting hemodialysis patients during December 1997 to April 1998. Consenting patients were recultured during May to July 1998 (median 120 days later). Clinical and laboratory data and functional status (1 to 10 scale: 1, normal function; 9, home attendant, not totally disabled; 10, disabled, living at home) were recorded. Results. Of 478 cultures performed, 20 (4.2%) were positive for VRE. Among the seven centers, the prevalence of VRE-positive cultures varied from 1.0 to 7.9%. Independently significant risk factors for a VRE-positive culture were a functional score of 9 to 10 (odds ratio 6.9, P<0.001), antimicrobial receipt within 90 days before culture (odds ratio 6.1, P<0.001), and a history of injection drug use (odds ratio 5.4, P=0.004). Conclusions. VRE-colonized patients were present at all seven participating centers, suggesting that careful infection-control precautions should be used at all centers to limit transmission. In agreement with previous studies, VRE colonization was more frequent in patients who had received antimicrobial agents recently, underscoring the importance of judicious antimicrobial use in limiting selection for this potential pathogen.

Original languageEnglish (US)
Pages (from-to)1511-1516
Number of pages6
JournalKidney international
Volume60
Issue number4
DOIs
StatePublished - Oct 2001

Keywords

  • Bacterial infection
  • Chronic hemodialysis
  • ESRD
  • Epidemic
  • Infection control
  • Pathogen
  • Transmission of VRE

ASJC Scopus subject areas

  • Nephrology

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    Tokars, J. I., Gehr, T., Jarvis, W. R., Anderson, J., Armistead, N., Miller, E. R., Parrish, J., Qaiyumi, S., Arduino, M., Holt, S. C., Tenover, F. C., Westbrook, G., & Light, P. (2001). Vancomycin-resistant enterococci colonization in patients at seven hemodialysis centers. Kidney international, 60(4), 1511-1516. https://doi.org/10.1046/j.1523-1755.2001.00955.x