Association between multidrug-resistant bacteria and outcomes in intensive care unit patients: a non-interventional study

In intensive care units (ICUs), infections by multidrug-resistant (MDR) microorganisms should be monitored to prevent healthcare-associated infections (HAIs). From 2018 to 2020, we investigated all medical records of patients admitted to the ICU of a public university hospital. All patients colonize...

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Published in:	Frontiers in public health Vol. 11; p. 1297350
Main Authors:	Martins, Alessandro Pacheco Silveira, da Mata, Camila Pacheco Silveira Martins, Dos Santos, Uener Ribeiro, de Araújo, César Augusto, Leite, Edna Marilea Meireiles, de Carvalho, Luciana Debortoli, Vidigal, Pedro Guatimosim, Vieira, Cristina Dutra, Dos Santos-Key, Simone Gonçalves
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 08-01-2024
Subjects:	active surveillance cultures Bacteria Critical Care Cross Infection - drug therapy healthcare-associated infection Humans intensive care unit Intensive Care Units invasive devices Male Meropenem multidrug-resistant bacteria Public Health Vancomycin active surveillance cultures multidrug-resistant bacteria healthcare-associated infection intensive care unit invasive devices
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Summary:	In intensive care units (ICUs), infections by multidrug-resistant (MDR) microorganisms should be monitored to prevent healthcare-associated infections (HAIs). From 2018 to 2020, we investigated all medical records of patients admitted to the ICU of a public university hospital. All patients colonized/infected by MDR microorganisms and submitted to active surveillance cultures (ASCs) were included. Male patients prevailed, and 9.5% were positive for MDR bacteria. In-hospital deaths were statistically significant ( < 0.05) for older patients, patients with orotracheal tube use during previous and current hospitalization, and patients with high blood pressure, cardiac and pulmonary diseases, and chronic kidney disease. Carbapenem resistant Enterobacteriaceae was the most frequently resistance profile, followed by extended-spectrum beta-lactamase. The diagnosis or evolution of HAIs was statistically significant ( < 0.0001) for patients treated with meropenem and vancomycin, and in-hospital deaths occurred in 29.5% of patients using polypeptides while the use of macrolides reduced the odds for mortality. The BRADEN Scale demonstrated that 50% of the patients were at high risk of dying. Patients hospitalized in the ICU, colonized or infected by MDR bacteria, using invasive medical devices, and with underlying medical conditions presented increased mortality rates. The prescription of meropenem and vancomycin should be carefully monitored once patients using these antimicrobials already have or develop an HAI.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Erika Paola Plata Menchaca, View Hospital, Qatar Reviewed by: Richard M. Mariita, Crystal IS Inc., United States Rodolpho M. Albano, Rio de Janeiro State University, Brazil
ISSN:	2296-2565 2296-2565
DOI:	10.3389/fpubh.2023.1297350