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Table 2 Bivariate assessment of characteristics associated with vancomycin-resistant enterococcus (VRE) acquisition among cases and controls

From: Colonization with antibiotic-susceptible strains protects against methicillin-resistant Staphylococcus aureus but not vancomycin-resistant enterococci acquisition: a nested case-control study

Variable

Controls a

N (%)

Cases a

N (%)

Odds ratio b

(95% CI)

P value

Total

248 (100%)

227 (100%)

  

Age

   

0.98

   < 45

24 (10%)

20 (9%)

1.0, reference

 

   45 to < 55

35 (14%)

31 (14%)

0.95 (0.43, 2.08)

 

   55 to < 65

51 (21%)

54 (24%)

1.13 (0.55, 2.35)

 

   65 to < 75

62 (25%)

58 (26%)

1.01 (0.49, 2.08)

 

   75+

76 (31%)

64 (28%)

0.97 (0.48, 1.98)

 

Male gender

127 (51%)

139 (61%)

0.72 (0.49, 1.04)

0.08

Comorbities

    

   Diabetes mellitus

72 (29%)

81 (36%)

1.43 (0.95, 2.13)

0.08

   End-stage renal disease

15 (6%)

29 (13%)

2.36 (1.21, 4.60)

0.01

   End-stage liver disease

11 (4%)

8 (4%)

0.79 (0.31, 2.05)

0.63

   Solid cancer

55 (22%)

64 (28%)

1.19 (0.74, 1.89)

0.47

   Hematologic malignancy

15 (6%)

18 (8%)

1.16 (0.56, 2.43)

0.69

ICU type

   

0.77

   Medical

92 (37%)

75 (33%)

0.88 (0.37, 2.06)

 

   Surgical

156 (63%)

152 (67%)

  

ICU admit to negative swab

   

< .0001

   1 day

186 (75%)

79 (35%)

1.0, reference

 

   2 days

48 (19%)

30 (13%)

1.46 (0.85, 2.52)

 

   ≥ 3 days

14 (6%)

118 (52%)

18.92 (10.23, 34.97)

 

Active wound

174 (70%)

184 (81%)

1.74 (1.07, 2.83)

0.03

Active rash

21 (8%)

40 (18%)

2.16 (1.22, 3.83)

0.01

Surgical procedures c

218 (88%)

175 (77%)

0.42 (0.25, 0.71)

0.001

Non-surgical procedures c

    

   Intubation

210 (85%)

214 (94%)

2.47 (1.25, 4.90)

0.01

   Central line

200 (81%)

212 (94%)

2.99 (1.60, 5.62)

0.001

   Arterial line

222 (90%)

211 (93%)

1.44 (0.73, 2.83)

0.29

   Chest tube

97 (39%)

93 (41%)

0.79 (0.49, 1.27)

0.32

   Surgical drain

106 (43%)

74 (33%)

0.61 (0.40, 0.93)

0.02

Labs c

    

   Albumin < 2

28 (11%)

56 (25%)

2.39 (1.43, 3.98)

0.001

   Creatinine > 2

74 (30%)

99 (44%)

2.03 (1.35, 3.05)

0.001

Colonization pressure

   

< .0001

   0

29 (12%)

10 (4%)

0.17 (0.07, 0.38)

 

   1 to < 4

70 (28%)

21 (9%)

0.15 (0.08, 0.27)

 

   4 to < 8

58 (24%)

48 (21%)

0.40 (0.24, 0.67)

 

   8 to < 12

41 (17%)

43 (19%)

0.50 (0.29, 0.87)

 

   12+

50 (20%)

105 (46%)

1.0, reference

 

Sensitive strain carrier d

14 (6%)

14 (6%)

1.08 (0.50, 2.34)

0.85

Antibiotic utilization c

    

   Aminoglycoside

24 (10%)

43 (19%)

2.27 (1.31, 3.93)

0.004

   Clindamycin

14 (6%)

22 (10%)

1.90 (0.93, 3.88)

0.08

   Macrolide

14 (6%)

30 (13%)

2.91 (1.47, 5.76)

0.002

   Fluoroquinolone

141 (57%)

182 (81%)

2.94 (1.91, 4.50)

< .0001

   First generation Cephalosporin

92 (37%)

68 (30%)

0.68 (0.45, 1.04)

0.08

   Second generation Cephalosporin

8 (3%)

6 (3%)

0.72 (0.24, 2.15)

0.56

   Third generation Cephalosporin

55 (22%)

107 (48%)

3.33 (2.20, 5.05)

< .0001

   Broad spectrum penicillin

1 (0.40%)

3 (1%)

2.56 (0.26, 25.24)

0.42

   Carbapenem

9 (4%)

21 (9%)

2.56 (1.13, 5.79)

0.02

   Anti-VRE antibiotics e

3 (1%)

9 (4%)

3.66 (0.95, 14.03)

0.06

   Other VRE antibiotics f

2 (0.81%)

3 (1%)

2.01 (0.32, 12.64)

0.46

  1. aCases and controls had a negative rectal surveillance swab and no prior history of VRE upon intensive care unit admission
  2. bAccounted for clustering by intensive care unit ward
  3. cAssessed during the two weeks prior to the initial negative surveillance culture through the period encompassing the subsequent negative or positive surveillance or clinical culture for VRE
  4. dSensitive strain refers to vancomycin-sensitive enterococci
  5. eAnti-VRE antibiotics include linezolid, synercid, daptomycin, and tigecycline
  6. fOther VRE antibiotics include doxycycline, nitrofurantoin
  7. CI, confidence interval.
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