Effect of Gastrointestinal Bleeding and Oral Medications on Acquisition of Vancomycin-Resistant Enterococcus faecium in Hospitalized Patients

• Published in: Clinical infectious diseases Vol. 35; no. 8; pp. 935 - 942
• Main Authors: Cetinkaya, Yesim, Falk, Pamela S., Mayhall, C. Glen
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.10.2002; University of Chicago Press
• Subjects: Administration, Oral; Antacids; Bacterial diseases; Biological and medical sciences; Bleeding; Case-Control Studies; Enterococcus faecium; Gastrointestinal Diseases - microbiology; Gastrointestinal Diseases - physiopathology; Gastrointestinal intubation; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Hemorrhage - etiology; Hospital admissions; Hospitalization; Human bacterial diseases; Humans; Infections; Infectious diseases; Major Articles; Medical sciences; Miscellaneous; Modeling; Predisposing factors; Retrospective Studies; Risk Factors; Superoxides; Vancomycin Resistance; Human; Drug; Oral administration; Cardiovascular disease; Infection; Vascular disease; Streptococcaceae; Enterococcus faecium; Risk factor; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Micrococcales; Protection; Gastric disease
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/342580

There has been minimal investigation of medications that affect gastrointestinal function as potential risk factors for the acquisition of vancomycin-resistant enterococci (VRE). We performed a retrospective case-control study, with control subjects matched to case patients by time and location of hospitalization. Strict exclusion criteria were applied to ensure that only case patients with a known time of acquisition of VRE were included. Control patients were patients with ⩾1 culture negative for VRE. The risk factors identified were use of vancomycin (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.7–6.0; P = .0003), presence of central venous lines (OR, 2.2; 95% CI, 1.04–4.6; P = .04), and use of antacids (OR, 2.9; 95% CI, 1.5–5.6; P = .002). Two protective factors included gastrointestinal bleeding (OR, 0.26; 95% CI, 0.08–0.79; P = .02) and use of Vicodin (Knoll Labs; hydrocodone and acetaminophen; OR, 0.93; 95% CI, 0.90–0.97; P = .0003). Changes in gastrointestinal function, whether due to bleeding or to the effects of oral medications, may affect whether patients become colonized with VRE.