Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit

Nicolás Francisco Fernández-Martínez, Sheila Cárcel-Fernández, Carmen De la Fuente-Martos, Rafael Ruiz-Montero, Bernardo R. Guzmán-Herrador, Rafael León-López, Francisco Javier Gómez, Julia Guzmán-Puche, Luis Martínez-Martínez and Inmaculada Salcedo-Leal
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Nicolás Francisco Fernández-Martínez: Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
Sheila Cárcel-Fernández: Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
Carmen De la Fuente-Martos: Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
Rafael Ruiz-Montero: Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
Bernardo R. Guzmán-Herrador: Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
Rafael León-López: Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
Francisco Javier Gómez: Department of Medicine, University of Granada, 18011 Granada, Spain
Julia Guzmán-Puche: Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
Luis Martínez-Martínez: Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
Inmaculada Salcedo-Leal: Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain

IJERPH, 2022, vol. 19, issue 3, 1-13

Abstract: Multidrug-resistant Gram-negative bacteria (MDR-GNB) are microorganisms that have acquired resistance to extended-spectrum antibacterials and constitute an emerging threat to public health. Although carriers are an important source of transmission in healthcare settings, data about risk factors for MDR-GNB carriage are limited. Therefore, we aimed to identify risk factors for MDR-GNB carriage upon intensive care unit (ICU) admission and to optimise screening strategies. We conducted a case–control study. Admissions of adult patients to the ICU of a 1000-bed hospital during a year were included. We collected sociodemographic, clinical and microbiological data and performed a multivariate logistic regression model. A total of 1342 patients resulted in 1476 episodes of ICU admission, 91 (6.2%) of whom harboured MDR-GNB (38.5% women; median age 63.9 years). The most frequently isolated pathogens were Escherichia coli (57%) and Klebsiella pneumoniae (16%). The most frequent resistance mechanism was production of extended-spectrum beta lactamases. MDR-GNB carriage was associated to liver cirrhosis (OR 6.54, 95% CI 2.17–19.17), previous MDR-GNB carriage (OR 5.34, 1.55–16.60), digestive surgery (OR 2.83, 1.29–5.89) and length of hospital stay (OR 1.01 per day, 1.00–1.03). Several risk factors for MDR-GNB carriage upon admission to a high-risk setting were identified; the main comorbidity was liver cirrhosis.

Keywords: antibacterial drug resistance; critical care; infection control; risk factors; gram negative bacteria; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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