Evidence map›Paper›PMID 41618378›Full record

ArticleAntimicrobial resistance and infection control2026

Natural clearance of colonization with vancomycin-resistant Enterococcus and carbapenemase-producing Enterobacterales: a 13-year study among territory-wide residents of residential care home for the elderly in Hong Kong.

Edmond Siu-Keung Ma, Raymond Wai-Man Lai, Vivien Wai-Man Chuang, Bianca Suet-Ying Shing, Leo Lui, Enoch Hsu, Emily Kiu, Hong Chen, Edwin Lok-Kin Tsui

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Edmond Siu-Keung MaInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China. edmond_sk_ma@dh.gov.hk.ORCID 0000-0003-3071-6256
Raymond Wai-Man LaiHospital Authority, Kowloon, Hong Kong Special Administrative Region, China.
Vivien Wai-Man ChuangHospital Authority, Kowloon, Hong Kong Special Administrative Region, China.
Bianca Suet-Ying ShingInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China.
Leo LuiInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China.
Enoch HsuInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China.
Emily KiuInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China.
Hong ChenInfection Control Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region, China.ORCID 0000-0001-8854-2119
Edwin Lok-Kin TsuiCentre for Health Protection, Department of Health, Kowloon, Hong Kong Special Administrative Region, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVancomycin-resistant Enterococcus (VRE) and carbapenemase-producing Enterobacterales (CPE) cause outbreaks in hospitals and the community. There is limited literature on the clearance time of VRE and CPE colonization. We reported the natural clearance time of VRE and CPE among residents of the Residential Care Home for the Elderly (RCHE) and the factors associated with prolonged colonization.

methodsThis retrospective study reviewed cases of VRE and CPE colonization reported to the Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region from 1 January, 2012 to 31 December, 2024. We reviewed the demographic characteristics and outcomes of the VRE and CPE cases when they were cleared of the bacteria or died during the follow-up period, up to 31 December 2024. Clearance of VRE and CPE was defined as negative culture results for at least two and three consecutive specimens collected at least 48 h apart at the RCHE respectively. We compared the clearance time of VRE and CPE using the Kaplan-Meier method and determined the factors influencing the duration of clearance by univariate and multiple Cox regression.

resultsA total of 3626 VRE cases and 4434 CPE cases were followed up. CPE cases tended to be older and had a higher proportion of females compared to VRE cases. There was no statistical difference in the types of homes between the two groups. The mortality rate of VRE (25.7%) was similar to that of CPE (25.1%). It was found that the carriage duration of CPE was significantly longer than that of VRE, as tested by the log-rank test (p < 0.01). Half of the VRE and CPE cases will clear the bacteria by 85 days and 131 days, respectively. The carriage duration for the majority (90%) of VRE and CPE cases was 400 and 818 days, respectively. After adjusting for all associated factors, a longer length of stay for readmission to hospitals and lower occupancy rates in RCHEs were significantly associated with prolonged carriage status.

conclusionsThe natural clearance duration of VRE and CPE provides useful information to improve guidelines of screening of previously colonized patients, and duration of contact precautions to prevent transmission of these resistant organisms among the vulnerable groups.

Indexed as

beta-LactamasesCarbapenem-Resistant EnterobacteriaceaeCarrier StateEnterobacteriaceaeEnterobacteriaceae InfectionsGram-Positive Bacterial InfectionsHomes for the AgedVancomycin-Resistant EnterococciAgedAged, 80 and overBacterial ProteinsFemaleHong KongHumansMaleNursing Home ResidentsBacterial Proteinsbeta-LactamasescarbapenemaseAntimicrobial resistanceCarbapenemase-producing EnterobacteralesColonizationEpidemiologyInfection controlVancomycin-resistant Enterococcus

Identifiers

PMID41618378
PMCPMC12930830

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.