Altoparlak et al identified risk factors for patient on a burn unit becoming colonized with vancomycin-resistant enterococci (VRE). This can help to identify patients who should be targeted for preventive measures. The authors are from Ataturk University in Erzurum, Turkey.
Patient selection: burn unit
Outcome: colonization with VRE (presence of culture for VRE from rectum, umbilicus, axilla, throat or burn wound AND no signs or symptoms of infection)
Risk factors for becoming colonized from multivariate analysis:
(1) more extensive burns (large total burn surface area)
(2) significant third degree burns
(3) glycopeptide antibiotic therapy (primarily vancomycin)
where:
• In Table 2 and in the discussion both third degree burns and glycopeptide use were associated with VRE colonization. In Table 3 the odds ratio for burn depth is 0.2 and for glycopeptide therapy is 0.07.
The prevalence of VRE colonization increased the longer that the patient was on the burn unit (especially after 21 days)
A risk factor not mentioned would be a high rate of VRE in hospital or community.
The rectum was the site most often colonized.
Some patients colonized with VRE had previously been identified as being colonized with vancomycin-sensitive enterococci (VSE).
The most active antibiotics against VRE were found to be tigecycline and linezolid.
