Risk factors of multidrug-resistant bacterial infections among patients admitted in a tertiary care hospital of north India
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.
Copyright (c) 2021 venkatesh Vaithiyam, Piyush Ranjan, Devashish Desai, Ankit Mittal, Arti Kapil, Naveet Wig, Ashutosh Biswas
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