Abstract

FLORES-PAREDES, Wilfredo. Epidemiology of intestinal tract colonization with vancomycin resistant enterococci in high risk patients in the Edgardo Rebagliati Martins National Hospital. Lima, Perú. Rev Med Hered [online]. 2010, vol.21, n.3, pp.128-139. ISSN 1018-130X.

Objectives: To determine the prevalence and the risk factors associated to colonization with vancomycin resistant enterococci (VRE) in high risk patients. Material and methods: The Hospital Rebagliati is a 1492-bed teaching hospital. A Cross-Sectional Study was applied to determine the point prevalence. The day of the study (August 23rd, 2004), 243 high risk patients were enrolled to the study and a stool samples were obtained by rectal swab for microbiology identification of VRE. To identify the risk factors associated with VRE colonization a Case-Control Study (28 cases and 28 controls) was done. Results: The prevalence of VRE colonization in high risk patients was 11.5% (28/243). The rate of colonization in high-risk wards (ICUs, transplant units, oncohematology, nephrology) and low-risk wards (the rest of inpatient units) was similar: 11.6% and 11.5% respectively. In internal medicine the rates were almost as high as in ICUs (16.9% and 18.2% respectively). Bed/chair-bound state, hemodialysis, exposure to multiple invasive procedures, and exposure to broad spectrum antibiotics were the risk factors related to VRE colonization. Having received a VRE related antibiotic (vancomycin, third-generation cephalosporins and antianaerobic drugs), particularly antianaerobic drugs, were related to VRE colonization. Conclusion: The VRE has emerged until becoming endemic inside the institution and great part of the hospital was already exposed. This emergence is basically due to deficient infection control techniques, the use of broad spectrum antibiotics, and the presence of reservoirs of VRE. The understanding of the epidemiology of VRE in the institution allows applying strategic measures to control its dissemination. (Rev Med Hered 2010;21:128-138).

Keywords : Vancomycin resistance; Enterococcus; colonization; epidemiology; surveillance.

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