Evaluation of the prevalence and risk factors for colonization by vancomycin-resistant Enterococcus among patients on dialysis

Evaluation of the prevalence and risk factors for colonization by vancomycin-resistant Enterococcus among patients on dialysis

Autor Barbosa, D. Google Scholar
Lima, L. Google Scholar
Silbert, S. Google Scholar
Sader, H. Google Scholar
Cendoroglo, M. Google Scholar
Draibe, S. Google Scholar
Camargo, L. Google Scholar
Vianna, L. Google Scholar
Belasco, A. Google Scholar
Sesso, R. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background Vancomycin-resistant Enterococcus (VRE) has been reported among long-term dialysis patients, although risk factors for VRE colonization are not well defined. This study alms to appraise the prevalence and risk factors for VRE colonization among patients on long-term dialysis therapy, as well as the mechanisms for dissemination of vancomycin resistance. Methods: This is a cross-sectional survey of 320 patients on long-term dialysis therapy at 2 hospitals of the Federal University of São Paulo from June 2001 to March 2003. Fecal samples were collected from each patient once a week for 1 month. Samples with positive test results for VRE were submitted to molecular typing through automated ribotyping. Results VRE prevalence was 14.4%. There were significant associations between VRE and dialysis type (hemodialysis, P = 0.04), number of hospitalizations (P = 0.03), low hemoglobin level (P = 0.03), and leukocytosis (P = 0.05). Among samples with VRE (n = 56), 25% were Enterococcus faecium; 10.7%, Enterococcus casseliflavus; 57.1%, Enterococcus grallinarum; and 3.6%, Enterococcus faecalis. All samples isolated were sensitive to telcoplanin, except for E faecium samples, which were strongly resistant, although 9 of 14 patients with this isolate presented the same ribogroup (111-S-4). Typing of 6 samples from 8 dialysis patients with Egallinarum was performed, showing a predominant ribogroup (112-S-4). Conclusion: Hospital environment, hemodialysis, anemia, and leukocytosis appear to be associated with VRE colonization. These results suggest that dissemination of these bacteria among patients on long-term dialysis therapy may be taking place.
Palavra-chave hemodialysis (HD)
vancomycin-resistant Enterococcus (VRE)
infection
molecular typing
Idioma Inglês
Data de publicação 2004-08-01
Publicado em American Journal of Kidney Diseases. Philadelphia: W B Saunders Co-Elsevier Inc, v. 44, n. 2, p. 337-343, 2004.
ISSN 0272-6386 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 337-343
Fonte http://dx.doi.org/10.1053/j.ajkd.2004.04.038
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000223172400020
Endereço permanente http://repositorio.unifesp.br/handle/11600/27861

Exibir registro completo




Arquivo

Arquivo Tamanho Formato Visualização

Não existem arquivos associados a este item.

Este item está nas seguintes coleções

Buscar


Navegar

Minha conta