RISK-FACTORS ASSOCIATED WITH VANCOMYCIN-RESISTANT ENTEROCOCCUS-FAECIUM INFECTION OR COLONIZATION IN 145 MATCHED CASE PATIENTS AND CONTROL PATIENTS

Risk factors and mortality associated with vancomycin-resistant Entero coccus faecium (VREF) infection or colonization were examined at a ter tiary care hospital by comparing 145 patients who had VREF isolates (c ases) to 145 patients with vancomycin-susceptible Enterococcus faecium (VSEF) isolates (controls), The number of deaths per 100 person-days of hospitalization after diagnosis did not differ significantly betwee n VREF patients (1.2) and VSEF patients (0.8). Multivariate analyses f ound that the duration of hospitalization (greater than or equal to 7 days), intrahospital transfer between floors, use of antimicrobials (i .e., vancomycin and third-generation cephalosporins), and duration of vancomycin use (greater than or equal to 7 days) was independently ass ociated with VREF infection or colonization, This study, which has a l arge sample size, confirms some earlier observations regarding risks f or VREF infection or colonization and identifies factors that may be p otentially exploited to develop interventional strategies for the cont rol of this emerging nosocomial problem.