Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study

Background: Vancomycin resistant enterococci (VRE) are now considered a global public health issue. In this study, we explored the relationship between vancomycin resistance incidence and various demographic and climatic factors. Methods: This retrospective study was performed between January 1st, 2...

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Main Authors: Jiongjiong Wang, Xiaoying Li, Xinying Du, Huiqun Jia, Hui Chen, Jian Wu, Guangcai Duan, Haiyan Yang, Ligui Wang
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Infectious Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772431X2400073X
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author Jiongjiong Wang
Xiaoying Li
Xinying Du
Huiqun Jia
Hui Chen
Jian Wu
Guangcai Duan
Haiyan Yang
Ligui Wang
author_facet Jiongjiong Wang
Xiaoying Li
Xinying Du
Huiqun Jia
Hui Chen
Jian Wu
Guangcai Duan
Haiyan Yang
Ligui Wang
author_sort Jiongjiong Wang
collection DOAJ
description Background: Vancomycin resistant enterococci (VRE) are now considered a global public health issue. In this study, we explored the relationship between vancomycin resistance incidence and various demographic and climatic factors. Methods: This retrospective study was performed between January 1st, 2014 and December 31st, 2021. Data covering the consumption of vancomycin, the prevalence of vancomycin resistance, and relevant demographics were collected. Spearman's rank correlation, beta regression, and spatial statistical analysis were performed using R version 4.2.2 and ArcGIS version 10.7. Results: Spearman's rank correlation described the positive relation between vancomycin consumption and the prevalence of vancomycin resistant Enterococcus faecium (VREfm). Multiple regression analysis showed that vancomycin consumption, rural population, proportion of population aged ≥65, annual temperature, and bed number in medical institutions per thousand people were significantly correlated with VREfm prevalence (r = 56.22, p < 0.001; r = 0.0002, p < 0.001; r = 0.06, p < 0.001; r = −0.07, p < 0.001; and r = −0.37, p < 0.001, respectively). Conclusions: Vancomycin utilization was the predominant factor contributing to VREfm resistance; the effects of rural populations and the proportion of the population aged ≥ 65 were significant but relatively minimal. Annual temperature and the number of beds in medical institutions per thousand people were protective factors against VREfm.
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spelling doaj-art-cd4ef10f7deb46f686c5adf11cd6646b2025-01-23T05:27:59ZengElsevierInfectious Medicine2772-431X2025-03-0141100159Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological studyJiongjiong Wang0Xiaoying Li1Xinying Du2Huiqun Jia3Hui Chen4Jian Wu5Guangcai Duan6Haiyan Yang7Ligui Wang8Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, ChinaChinese PLA Center for Disease Control and Prevention, Beijing 100071, ChinaChinese PLA Center for Disease Control and Prevention, Beijing 100071, ChinaChinese PLA Center for Disease Control and Prevention, Beijing 100071, ChinaChinese PLA Center for Disease Control and Prevention, Beijing 100071, ChinaDepartment of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, ChinaDepartment of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, ChinaDepartment of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China; Corresponding author.Chinese PLA Center for Disease Control and Prevention, Beijing 100071, China; Corresponding author.Background: Vancomycin resistant enterococci (VRE) are now considered a global public health issue. In this study, we explored the relationship between vancomycin resistance incidence and various demographic and climatic factors. Methods: This retrospective study was performed between January 1st, 2014 and December 31st, 2021. Data covering the consumption of vancomycin, the prevalence of vancomycin resistance, and relevant demographics were collected. Spearman's rank correlation, beta regression, and spatial statistical analysis were performed using R version 4.2.2 and ArcGIS version 10.7. Results: Spearman's rank correlation described the positive relation between vancomycin consumption and the prevalence of vancomycin resistant Enterococcus faecium (VREfm). Multiple regression analysis showed that vancomycin consumption, rural population, proportion of population aged ≥65, annual temperature, and bed number in medical institutions per thousand people were significantly correlated with VREfm prevalence (r = 56.22, p < 0.001; r = 0.0002, p < 0.001; r = 0.06, p < 0.001; r = −0.07, p < 0.001; and r = −0.37, p < 0.001, respectively). Conclusions: Vancomycin utilization was the predominant factor contributing to VREfm resistance; the effects of rural populations and the proportion of the population aged ≥ 65 were significant but relatively minimal. Annual temperature and the number of beds in medical institutions per thousand people were protective factors against VREfm.http://www.sciencedirect.com/science/article/pii/S2772431X2400073XVancomycin-resistanceEnterococcusGeneralized linear modelBeta regression
spellingShingle Jiongjiong Wang
Xiaoying Li
Xinying Du
Huiqun Jia
Hui Chen
Jian Wu
Guangcai Duan
Haiyan Yang
Ligui Wang
Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
Infectious Medicine
Vancomycin-resistance
Enterococcus
Generalized linear model
Beta regression
title Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
title_full Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
title_fullStr Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
title_full_unstemmed Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
title_short Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study
title_sort unveiling the drivers of vancomycin resistant enterococcus in china a comprehensive ecological study
topic Vancomycin-resistance
Enterococcus
Generalized linear model
Beta regression
url http://www.sciencedirect.com/science/article/pii/S2772431X2400073X
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