Rectal culture screening for vancomycin-resistant enterococcus in chronic haemodialysis patients
만성 혈액투석 환자에서 반코마이신 내성 장구균 검출을 위한 직장 배양검사 : 위음성률과 집락형성의 지속 시기
- 주제(키워드) vancomycin-resistant enterococci , haemodialysis , end-stage renal disease
- 발행기관 아주대학교
- 지도교수 신규태
- 발행년도 2013
- 학위수여년월 2013. 2
- 학위명 박사
- 학과 및 전공 일반대학원 의학계열
- 실제URI http://www.dcollection.net/handler/ajou/000000013488
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Infection or colonisation with vancomycin-resistant enterococci (VRE) is common in chronic haemodialysis(HD) patients. However, there is limited information on the duration of VRE colonisation or on the reliability of consecutive negative rectal cultures to determine the clearance of VRE in chronic HD patients. Chronic HD patients from whom VRE was isolated were examined retrospectively. Rectal cultures were collected more than 3 times, at least 1 week apart, between 1 June 2003 and 1 March 2010. The results of the sequential VRE cultures and patients’ data were analyzed. Among 812 patients from whom VRE was isolated, 89 were chronic HD patients and 92 had three consecutive negative cultures. It took 60.7±183.9 and 111.4±155.4 days to collect three consecutive negative cultures in the 83 non-chronic haemodialysis patients and nine chronic haemodialysis patients, respectively (P= 0.011). The independent risk factors for more than three negative sequential rectal cultures were glycopeptide (odds ratio [OR], 2.155; P=0.003)and hospital day(OR, 1.009; P=0.001). After three consecutive negative rectal cultures, two of the six chronic HD patients, and 10 out of 36 patients were culture-positive again. In conclusion, a significant proportion of patients colonised with VRE cannot be detected even after three negative weekly rectal cultures, and the duration of VRE colonisation in chronic haemodialysis patients tends to be prolonged. These results may be contributing to the continued increase in the prevalence of VRE.
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ABSTRACT •••••••••••••••••••••••••••••••••••••••••••• i
TABLE OF CONTENTS •••••••••••••••••••••••••••••••• ii
LIST OF FIGURES ••••••••••••••••••••••••••••••••••••• iii
LIST OF TABLES ••••••••••••••••••••••••••••••••••••• iv
Ⅰ. INTRODUCTION ••••••••••••••••••••••••••••••••••••1
Ⅱ. MATERIALS AND METHODS •••••••••••••• 2
1. Study design and population •••••••••••••••••••••••••2
2. Microbiology methods •••••••••••••••••••••••••••2
3. Analysis •••••••••••••••••••••••••••••••••••••••••3
Ⅲ. RESRLTS ••••••••••••••••••••••••••••••••••••••••••4
Ⅳ. DICUSSION •••••••••••••••••••••••••••••••••••••••••••10
Ⅴ. CONCLUSION ••••••••••••••••••••••••••••••••••••••••13
REFERENCES ••••••••••••••••••••••••••••••••••••••••14
국문요약 ••••••••••••••••••••••••••••••••••••••••••••••17
