本病例對照研究乃探討南部某醫學中心2005年11月至2006年3月間 發生萬古黴素抗藥性腸球菌(VRE)移生事件之相關危險因子，以1：2病例對照配對方式，共選取102名研究對象，透過病歷紀錄以收集相關資料，如慢性病數、疾病嚴重度、近三個月住院(機構)史、腹部手術否、住院單位、加護單位停留天數、抗生素使用狀況（含種類與天數、使用Vancomycin、第三代頭孢子素、Metronidazole等）。以相對危險對比值(Odd’s Ratio, OR)描述各變項與VRE之關聯性，進一步以邏輯複迴歸分析確認VRE移生事件之相關危險因子，結果發現，研究對象中若有「抗生素使用≥3種」及「抗生素使用天數≥7天」之情形者，出現VRE移生事件的危險性是沒有這樣使用抗生素者的5.8倍及4.5倍。故建議若成人加護單位患者當使用抗生素種類超過三種，且使用天數長達七天以上，可主動篩檢其是否有VRE移生發生，以及早發現病人是否為VRE移生帶原者，避免病人本身發生感染的機會，也避免單位其他病人或環境發生移生的可能。

The aim of this case-control study was to explore the risk factors of Vancomycin-resistant enterococcus (VRE) colonization in a medical center of southern Taiwan. The ratio of 1:2, with one case to two controls, was applied in regard to the samples. A total of 102 patient subjects were included from intensive care units during the four month period from Nov. 2005 to Mar. 2006. There were 34 patients with VRE colonization, after the lab had identified and matched a selected 68 patients without VRE colonization as control, from the same ward. Information was then collected, such as on: co-morbidity, morbidity severity assessment with APARCH II score, experience of hospitalization or institutionalization during the recent 3 months, having undergone an abdominal operation, length of ICU stay, multi-class of antimicrobial usage, and length of antibiotic usage, by chart review. The Odd’s Ratio (OR) was applied to describe the risk of VRE colonization and multiple logistic regression analysis was used to determine risk factors in advance. The results show the risk of 5.8 times and 4.5 times regarding VRE colonization in using an antimicrobial with more than 3 classes and over 7 days in length to compare with fewer than 3 categories and under 7 days in antimicrobial usage, respectively. According to the study results, we suggest that when patients use antimicrobial with more than 3 classes or more than 7 days they should be actively screened for early detection to prevent a VRE colonization outbreak among intensive care units patients.

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