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KMID : 0984720060380050242
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Infection and Chemotherapy
2006 Volume.38 No. 5 p.242 ~ p.249
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Epidemiology and Clinical Significance of Bacteriuria Caused by Vancomycin-Resistant Enterococci
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Choi Won-Suk
Seo Yu-Bin
Jo Yu-Mi
Kim Jeong-Yeon
Kee Sae-Yoon
Jeong Hye-Won
Song Joon-Young
Cheong Hee-Jin
Song Ki-Joon
Kim Woo-Joo
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Abstract
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Background : Vancomycin-resistant enterococci (VRE) have been important pathogen of nosocomial
infections and isolated most commonly from urine specimens. However, the clinical significance of
VRE bacteriuria remains unknown. The objectives of this study are to describe the frequency, related
factors and outcomes of VRE bacteriuria, and to compare epidemiologic data and outcomes between
the subgroups: symptomatic urinary tract infection (UTI), asymptomatic bacteriuria, and colonization.
Materials and Methods : For patients with urine culture positive for VRE between August 1, 2002
and June 30, 2005, we collected clinical data and performed a retrospective analysis. According to
Centers for Disease Control and Prevention (CDC), patients were classified as symptomatic UTI,
asymptomatic bacteriuria, colonization and undetermined.
Results : Total 144 episodes (2.88%), in 58 patients, of 5,008 urine specimens were positive for
VRE during the study period. Frequency of antimicrobial exposure history, especially 3rd generation
cephalosporin, indwelling urinary catheter, and ICU stay at the time of culture was high in patients
with VRE bacteriuria. In VRE bacteriuria, symptomatic UTI was only 24.5%. Instead the majority of the
patients (71.4%) was colonized in urine with VRE or had asymptomatic bacteriuria. In comparison
between symptomatic UTI group and combined group of asymptomatic bacteriuria and colonization,
most demographic data and clinical features including hospital day and mortality had no significant
difference except one, male sex.
Conclusion : Most patients with VRE bacteriuria were classified as asymptomatic bacteriuria and
colonization and only one-fourth of patients with VRE bacteriuria require antibiotic therapy. Therefore,
clinicians should decide to initiate antibiotic therapy after consideration of clinical significance of VRE
bacteriuria.
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KEYWORD
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Enterococcus, Vancomycin resistance, Bacteriuria, Urinary tract infrection
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