Vancomycin-resistant enterococci colonization does not increase mortality in end-stage kidney failure: a case-control study

J Hosp Infect. 2013 Dec;85(4):289-96. doi: 10.1016/j.jhin.2013.09.005. Epub 2013 Sep 21.

Abstract

Background: Vancomycin-resistant enterococci (VRE) colonization is a frequent occurrence in patients with renal failure. Understanding the impact of VRE colonization on this group of patients has considerable clinical applicability.

Aim: To understand whether VRE colonization in renal patients has an impact on number of admissions to hospital, length of stay, and mortality.

Methods: A retrospective case-control study of renal dialysis patients was performed between 2000 and 2010. Cases were 134 VRE-colonized patients requiring renal replacement therapy and matched controls were 137 non-colonized patients with the same baseline characteristics. Matched cases and controls were analysed for differences in number of admissions, length of stay, and mortality.

Findings: There was no difference in mortality between colonized and non-colonized patients (hazard ratio: 1.14; 95% confidence interval: 0.78-1.69; P = 0.49). Length of stay for colonized patients was 7.29 days compared with 4.14 days (P < 0.001). The number of admissions for VRE-colonized patients was not significantly different compared with controls (9.34 vs 8.33, P = 0.78).

Conclusion: VRE colonization did not increase mortality in renal patients but did contribute to increased length of stay.

Keywords: Colonization; Dialysis; Renal; Vancomycin-resistant enterococci.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carrier State / microbiology*
  • Case-Control Studies
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification
  • Female
  • Gram-Positive Bacterial Infections / complications*
  • Gram-Positive Bacterial Infections / microbiology*
  • Hospitalization
  • Humans
  • Kidney Failure, Chronic / mortality*
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Vancomycin Resistance*
  • Young Adult