Risk factors of multidrug-resistant bacterial infections among patients admitted in a tertiary care hospital of north India

  • Venkatesh Vaithiyam Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Piyush Ranjan Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Devashish Desai Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Ankit Mittal Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Arti Kapil Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
  • Naveet Wig Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Ashutosh Biswas Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
Keywords: Infectious disease, Antimicrobial resistance, Multi drug resistant bacterial infection

Abstract

Introduction: Infections with drug-resistant organisms (DRO) have been associated with poor patient outcomes. To tackle this global problem, it is necessary to understand the risk factors that predispose to infections with DRO.

Methodology: This was a prospective observational study conducted over a three-year period at a tertiary-care hospital. Bacterial culture isolates from patients admitted in medicine wards with community or hospital-acquired infections were included. Logistic regression analysis was used to determine risk factors for drug-resistant infections.

Results: Of the 295 patients with 323 isolates included, 40 (12.3%) had non-MDR (N-MDR) infections, 86 (26.6 %) had MDR infections and 197 (61%) had possible extensively drug-resistant (P-XDR) infections. History of previous admission in the preceding three months (Odds Ratio, OR = 4.53, 95% Confidence interval, CI = 1.8 – 11.42, p = -0.01), high SOFA score at admission (OR = 1.14, 95% CI = 1.0 – 1.290, p = -0.039) and prolonged duration of ventilation (OR = 1.25, 95% CI = 1.05 – 1.41, p = -0.012) were independently associated P-XDR infections when compared to patients with N-MDR.

Conclusions: High rate of multidrug-resistant infections in the studied area is alarming. In this single-centre study, we elicited various risk factors for drug-resistant bacterial infections ranging from patient characteristics to iatrogenic risk factors during the hospital stay. Infections with P-XDR and MDR isolates independently increased hospital and ICU stay duration and were associated with increased mortality.

Author Biographies

Venkatesh Vaithiyam, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Junior resident, Department of Medicine

Piyush Ranjan, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Additional Professor, Department of Medicine

Devashish Desai, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Senior Resident, Department of Medicine and Microbiology

Ankit Mittal, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Senior resident, Department of Medicine and Microbiology All India Institute of Medical Sciences

Arti Kapil, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

Professor, Department of Microbiology 

Naveet Wig, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Professor, Head of the department of Medicine

Ashutosh Biswas, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

Professor, Department of medicine

Published
2021-04-30
How to Cite
1.
Vaithiyam V, Ranjan P, Desai D, Mittal A, Kapil A, Wig N, Biswas A (2021) Risk factors of multidrug-resistant bacterial infections among patients admitted in a tertiary care hospital of north India. J Infect Dev Ctries 15:544-551. doi: 10.3855/jidc.13963
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Original Articles