Background: Vancomycin-resistant and frequently colonize nursing facility (NF) residents, creating opportunities for vancomycin-resistant (VRE) transmission and dissemination of mobile genetic elements conferring antimicrobial resistance. Most VRE studies do not speciate; our study addresses this lack and compares the epidemiology of and .
Methods: We enrolled 651 newly admitted patients from 6 different NFs and collected swabs from several body sites at enrollment, 14 days, 30 days, and monthly thereafter for up to 6 months. The VRE were speciated using a duplex polymerase chain reaction. We used multinomial logistic regression models to compare risk factors associated with colonization of and
Results: Overall, 40.7% were colonized with , , or both. At enrollment, more participants were colonized with (17.8%) than (8.4%); 3.2% carried both species. was carried twice as long as (69 days and 32 days, respectively), but incidence rates were similar (, 3.9/1000 person-days vs , 4.1/1000 person-days). Length of stay did not differ by species among incident cases. Residents who used antibiotics within the past 30 days had a greater incidence of both (odds ratio [OR] = 2.89; 95% confidence interval [CI], 1.82-4.60) and (OR = 1.80; 95% CI, 1.16-2.80); device use was most strongly associated with the incidence of colonization (OR = 2.01; 95% CI, 1.15-3.50).
Conclusions: Recent increases in vancomycin-resistant prevalence may reflect increased device use and longer duration of carriage.
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| http://dx.doi.org/10.1093/ofid/ofz553 | DOI Listing |
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