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Journal of Korean Academy of Fundamentals of Nursing 2008;15(4): 522
중환자실 VRE 균집락과 획득발생 위험요인
한수하1, 박호란2
1순천향대학교 부천병원 감염관리실
2가톨릭대학교 간호대학
Risk Factors for Colonization and Acquisition with Vancomycin-Resistant Enterococci in Intensive Care Units
Su-Ha Han1, Ho-Ran Park2
1Department of infection control, Soonchunhyang University Bucheon Hospital
2College of Nursing, The Catholic University of Korea
Purpose: In this study active surveillance culture for ICU patients, in whom the risk of VRE infection was high were conducted, and through this the VRE colonization rate and the characteristics of the colonization were examined and risk factors involved in VRE colonization and acquisition were analyzed.
Method: This research was performed with 635 patients admitted to ICU between July 1 and December 31, 2006.
Results: On admission to ICU, the VRE colonization rate was 2.36%, 93% identified from active surveillance culture. The VRE colonization rate was significantly higher in those patients with cancer (OR=9.43; 95% CI=1.38${sim}$62.50; P=.022), liver cirrhosis (OR=55.5; 95% CI=7.29${sim}$500; P=.005), transferred from other hospitals (OR=200; 95% CI=22.73${sim}$1000; P=.000), high APACHE II score (OR=1.107; 95% CI=1.010${sim}$1.213; P=.029), or antibiotics within the last 3 months (OR=15.87; 95% CI=2.27${sim}$111.11; P=.005). The VRE acquisition rate was 5.2%. It was significantly higher in those who were using a ventilator (OR=26.31; 95% CI=5.13${sim}$142.86; P=.000), three or more kinds of antibiotics during admission (OR=58.82; 95% CI=16.13${sim}$200; P=.000), or high APACHE II score (OR=1.16; 95% CI=1.08${sim}$ 1.24; P=.000).
Conclusion: The results of this study show that active surveillance culture can detect VRE colonization on admission to ICU and those who have acquired VRE in ICU. The analyzed VRE colonization and risk factors of VRE acquisition are expected to be useful in establishing guidelines for preventing VRE infection in ICU.
Key words: Vancomycin | Resistance | Enterococcus | Intensive Care Units | Infection Control
주요어: 반코마이신 | 내성 | 장구균 | 중환자실 | 감염관리