Temporal trends of enterococcal and vancomycin-resistant Enterococcus faecium bacteraemia in the northern Dutch-German cross-border region: A 10-y multicentre analysis (2013-2022).

Cansu Cimen, Andreas Voss, Josef Hellkamp, Axel Hamprecht, Matthijs S Berends
Author Information
  1. Cansu Cimen: Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany; Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: cansu.cimen.van.dijck@uni-oldenburg.de.
  2. Andreas Voss: Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  3. Josef Hellkamp: Institute of Medical Microbiology and Virology, Klinikum Oldenburg, Oldenburg, Germany.
  4. Axel Hamprecht: Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany; Institute of Medical Microbiology and Virology, Klinikum Oldenburg, Oldenburg, Germany.
  5. Matthijs S Berends: Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Medical Epidemiology, Certe Medical Diagnostics and Advice Foundation, Groningen, The Netherlands.

Abstract

OBJECTIVE: To analyse the trends in occurrence of enterococcal and vancomycin-resistant Enterococcus faecium (VREfm) bacteraemia in the northern Dutch-German cross-border region.
METHODS: A retrospective cross-sectional study was conducted using positive blood culture results from two university hospitals, the University Medical Centre Groningen (UMCG) and the Klinikum Oldenburg (KOL) between 1 January 2013 to 31 December 2022.
RESULTS: Over the 10-y period, 738 enterococcal bacteraemia episodes were observed at KOL and 1091 at UMCG, involving 685 and 999 patients, respectively. E. faecium was the predominant species in both institutions (60.3% at KOL and 60.8% at UMCG). The median age of patients with enterococcal, E. faecium, E. faecalis and VREfm bacteraemia was consistently higher at KOL than at UMCG (p=.029). In both institutions, over half of the enterococcal bacteraemia cases (53.4% at KOL, 55.8% at UMCG) were observed in intensive care units and haematology/oncology wards. From 2018 to 2022, UMCG had higher overall incidence rates of E. faecium, and E. faecalis bacteraemia, while KOL had a significantly higher incidence of VREfm (0.56 vs. 0.05 per 10,000 patient-d, p<.0001). There was a significant upward trend in VREfm bacteraemia cases (p=.01) and in the proportion of VREfm among bacteraemia caused by E. faecium (p=.027) at KOL, but such a trend was not observed at UMCG during the study period.
CONCLUSIONS: The results reveal a significant difference in VREfm bacteraemia occurrences between a German and Dutch hospital in a cross-border region, reflecting national trends yet showing regional variation.

Keywords

Word Cloud

Created with Highcharts 10.0.0bacteraemiafaeciumUMCGKOLVREfmEenterococcalEnterococcustrendscross-borderobservedhigherp=vancomycin-resistantnorthernDutch-Germanregionstudyresults202210-yperiodpatientsinstitutions608%faecaliscasesincidence0significanttrendOBJECTIVE:analyseoccurrenceMETHODS:retrospectivecross-sectionalconductedusingpositivebloodculturetwouniversityhospitalsUniversityMedicalCentreGroningenKlinikumOldenburg1January201331DecemberRESULTS:738episodes1091involving685999respectivelypredominantspecies3%medianageconsistently029half534%55intensivecareunitshaematology/oncologywards2018overallratessignificantly56vs05per10000patient-dp<0001upward01proportionamongcaused027CONCLUSIONS:revealdifferenceoccurrencesGermanDutchhospitalreflectingnationalyetshowingregionalvariationTemporalregion:multicentreanalysis2013-2022BacteraemiaCross-borderhealthcareGermanyVancomycin-resistantNetherlands

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