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Independent risk factors for the co-colonization of vancomycin-resistant Enterococcus faecalis and methicillin-resistant Staphylococcus aureus in the region most endemic for vancomycin-resistant Staphylococcus aureus isolation

  • K. HayakawaEmail author
  • D. Marchaim
  • P. Bathina
  • E. T. Martin
  • J. M. Pogue
  • B. Sunkara
  • S. Kamatam
  • K. Ho
  • L. B. Willis
  • M. Ajamoughli
  • D. Patel
  • A. Khan
  • K. P. Lee
  • U. Suhrawardy
  • K. K. Jagadeesh
  • S. M. L. Reddy
  • M. Levine
  • F. Ahmed
  • A. M. Omotola
  • M. Mustapha
  • J. A. Moshos
  • M. J. Rybak
  • K. S. Kaye
Article

Abstract

In the majority of cases of vancomycin-resistant Staphylococcus aureus (VRSA), vancomycin-resistant Enterococcus faecalis (VR E. faecalis) served as the vanA donor to S. aureus. Previous studies that evaluated the risk factors for co-colonization with VRE and MRSA did not differentiate between VR E. faecalis and VR E. faecium. This study aimed to identify variables associated with VR E. faecalis and MRSA co-colonization. A retrospective case–control study from January 2008 to December 2009 was conducted at the Detroit Medical Center. Data were extracted from charts and pharmacy records. Unique patients co-colonized with VR E. faecalis and MRSA (defined as isolation of MRSA within 7 days of VR E. faecalis isolation) were compared with patients with VR E. faecalis who were not co-colonized with MRSA. A total of 546 patients with VR E. faecalis isolation were identified. 85 (15.6 %) VR E. faecalis patients were co-colonized with MRSA and 461 (84.4 %) VR E. faecalis patients were not co-colonized with MRSA. The mean age of the study cohort was 65.9 ± 16.4 years, 424 (77.7 %) were African–American, and 270 (49.5 %) were residing in long-term care institutions. Independent predictors of co-colonization of VR E. faecalis and MRSA were male gender, impaired consciousness, ICU stay prior to VR E. faecalis isolation, indwelling devices, and isolation of VR E. faecalis from wounds. MRSA was frequently isolated from the same culture specimen as VR E. faecalis (n = 39, 45.9 %), most commonly from wounds. This large study of patients with VR E. faecalis identified the severity of illness, indwelling devices, and chronic wounds as independent predictors of co-colonization with VR E. faecalis and MRSA

Keywords

Impaired Consciousness Surveillance Culture vanA Gene Functional Status Deterioration Chronic Skin Ulcer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

KSK is supported by the National Institute of Allergy and Infectious Diseases (NIAID); DMID Protocol Number: 10–0065. All other authors report no conflicts.

Funding

None declared.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • K. Hayakawa
    • 1
    • 5
    Email author
  • D. Marchaim
    • 1
  • P. Bathina
    • 1
  • E. T. Martin
    • 2
  • J. M. Pogue
    • 3
  • B. Sunkara
    • 1
  • S. Kamatam
    • 1
  • K. Ho
    • 1
  • L. B. Willis
    • 1
  • M. Ajamoughli
    • 1
  • D. Patel
    • 1
  • A. Khan
    • 1
  • K. P. Lee
    • 1
  • U. Suhrawardy
    • 1
  • K. K. Jagadeesh
    • 1
  • S. M. L. Reddy
    • 1
  • M. Levine
    • 1
  • F. Ahmed
    • 1
  • A. M. Omotola
    • 1
  • M. Mustapha
    • 1
  • J. A. Moshos
    • 1
  • M. J. Rybak
    • 1
    • 4
  • K. S. Kaye
    • 1
  1. 1.Division of Infectious Diseases, Detroit Medical CenterWayne State UniversityDetroit, MIUSA
  2. 2.Department of Pharmacy PracticeWayne State UniversityDetroitUSA
  3. 3.Department of Pharmacy ServicesDetroit Medical CenterDetroitUSA
  4. 4.Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health SciencesWayne State UniversityDetroitUSA
  5. 5.Division of Infectious Diseases5 HudsonDetroitUSA

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