Risk factors for acquiring XXXX -resistant enterococci and clinical outcomes at a Canadian tertiary-care hospital.

@entity869 @entity1 @entity2259 @entity281
The number of @entity869 -resistant enterococci (ARE) was noted to be increased at our teaching hospital. To determine the risk factors for acquiring this organism and to compare clinical outcomes, over a 5-month period 38 @entity1 infected or colonized with ARE were compared with 76 @entity1 , infected or colonized with @entity869 -susceptible enterococci (ASE). Risk factors included nosocomial acquisition, duration of hospitalization, admission to a medical service, prior antimicrobial therapy, and combination therapy for at least 7 days. The mortality rate of @entity1 infected or colonized with ARE was higher than that of @entity1 infected or colonized with ASE (34 versus 14%; P = 0.03), but most deaths did not appear to be related to @entity281 . Over a 2-year period, 16 @entity1 with ARE @entity2259 were also compared with 23 @entity1 with @entity2259 . The risk factors associated with ARE @entity2259 also included nosocomial acquisition, duration of hospitalization, and prior antimicrobial therapy. The mortality of @entity1 with ARE @entity2259 was also higher than that of @entity1 with @entity2259 (81 versus 30%; P = 0.003), with most deaths being due to the underlying disease or a complication of it. Typing of ARE isolates by pulsed-field gel electrophoresis showed that two genotypes predominated in our institution. A prolonged hospital stay, exposure to multiple antimicrobial agents, and perhaps nosocomial transmission are important factors in acquiring ARE. The presence of ARE may also be a marker for poor outcome.
