%0 Journal Article
%T Vancomycin-resistant Enterococcus faecium: admission prevalence, sequence types and risk factors-a cross-sectional study in seven German university hospitals from 2014 to 2018.
%A Rohde AM
%A Walker S
%A Behnke M
%A Eisenbeis S
%A Falgenhauer L
%A Falgenhauer JC
%A Häcker G
%A Hölzl F
%A Imirzalioglu C
%A Käding N
%A Kern WV
%A Kola A
%A Kramme E
%A Mischnik A
%A Peter S
%A Rieg S
%A Rupp J
%A Schneider C
%A Schwab F
%A Seifert H
%A Tacconelli E
%A Tobys D
%A Trauth J
%A Weber A
%A Xanthopoulou K
%A Zweigner J
%A Higgins PG
%A Gastmeier P
%A  
%J Clin Microbiol Infect
%V 29
%N 4
%D Apr 2023
%M 36481293
%F 13.31
%R 10.1016/j.cmi.2022.11.025
%X <B>OBJECTIVE: </B>Assessment of vancomycin-resistant Enterococcus faecium (VREfm) prevalence upon hospital admission and analysis of risk factors for colonization.<BR><B>METHODS: </B>From 2014 to 2018, patients were recruited within 72 hours of admission to seven participating German university hospitals, screened for VREfm and questioned for potential risk factors (prior multidrug-resistant organism detection, current/prior antibiotic consumption, prior hospital, rehabilitation or long-term care facility stay, international travel, animal contact and proton pump inhibitor [PPI]/antacid therapy). Genotype analysis was done using cgMLST typing. Multivariable analysis was performed.<BR><B>RESULTS: </B>In 5 years, 265 of 17,349 included patients were colonized with VREfm (a prevalence of 1.5%). Risk factors for VREfm colonization were age (adjusted OR [aOR], 1.02; 95% CI, 1.01-1.03), previous (aOR, 2.71; 95% CI, 1.87-3.92) or current (aOR, 2.91; 95% CI, 2.60-3.24) antibiotic treatment, prior multidrug-resistant organism detection (aOR, 2.83; 95% CI, 2.21-3.63), prior stay in a long-term care facility (aOR, 2.19; 95% CI, 1.62-2.97), prior stay in a hospital (aOR, 2.91; 95% CI, 2.05-4.13) and prior consumption of PPI/antacids (aOR, 1.29; 95% CI, 1.18-1.41). Overall, the VREfm admission prevalence increased by 33% each year and 2% each year of life. 250 of 265 isolates were genotyped and 141 (53.2%) of the VREfm were the emerging ST117. Multivariable analysis showed that ST117 and non-ST117 VREfm colonized patients differed with respect to admission year and prior multidrug-resistant organism detection.<BR><B>CONCLUSIONS: </B>Age, healthcare contacts and antibiotic and PPI/antacid consumption increase the individual risk of VREfm colonization. The VREfm admission prevalence increase in Germany is mainly driven by the emergence of ST117.