VRE in cirrhotic patients

• Published in: BMC infectious diseases 2019-08, Vol.19 (1), p.711-711, Article 711
• Main Authors: Barger, Melissa, Blodget, Emily, Pena, Sol, Mack, Wendy, Fong, Tse-Ling
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotic Prophylaxis; Ascites; Child; Cirrhosis; Daptomycin; Demographic aspects; Development and progression; Enterococcal infections; Female; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - mortality; Hospital patients; Humans; Infection; Intensive Care Units; Length of Stay; Liver; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - microbiology; Liver Cirrhosis - mortality; Liver disease; Liver diseases; Liver Transplantation - adverse effects; Male; Medical centers; Medical research; Microbial drug resistance; Middle Aged; Morbidity; Mortality; Neomycin; Organ transplantation; Peritonitis; Peritonitis - microbiology; Peritonitis - prevention & control; Prophylaxis; Retrospective Studies; Rifaximin; Risk Factors; Surgery; Tigecycline; Vancomycin; Vancomycin Resistance; Vancomycin-resistant enterococcus
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4352-1

Vancomycin resistant enterococci (VRE) infections are of increasing concern in many hospitalized patients. Patients with cirrhosis are at added risk of infection with VRE, with associated increased risk for complications from infections. The goals of this study were to: [1] identify risk factors for VRE amongst cirrhotic patients before liver transplantation, and [2] evaluate risk of morbidity and mortality at 30-days and one-year after VRE infection. Chart review of 533 cirrhotic patients hospitalized at a tertiary medical center was performed. Patients infected with VRE (n = 65) were separately compared to patients infected with gram-negative organisms (n = 80) and uninfected patients (n = 306). In multivariable logistic regression analyses, female gender (OR 3.73(95% CI1.64,8.49)), severity of liver disease measured by higher Child Pugh scores (OR 0.37(95%CI 0.16,0.84)), presence of ascites (OR 9.43(95% CI 3.22,27.65) and any type of dialysis (OR 3.31,95% CI (1.21,9.04), oral antibiotic prophylaxis for spontaneous bacterial peritonitis and rifaximin use were statistically significantly associated with VRE infection (OR 2.37 (95%CI 1.27, 4.42)). VRE-infected patients had significantly longer mean ICU and total hospital stays (both p