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

Author

Listed:
  • Nicolás Francisco Fernández-Martínez

    (Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    These authors contributed equally to this article and share first authorship.)

  • Sheila Cárcel-Fernández

    (Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    Intensive Care Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Department of Medicine, University of Granada, 18011 Granada, Spain
    These authors contributed equally to this article and share first authorship.)

  • Carmen De la Fuente-Martos

    (Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    Intensive Care Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain)

  • Rafael Ruiz-Montero

    (Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    Department of Medical and Surgical Sciences, University of Córdoba, 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
    Intensive Care Unit, Reina Sofía University Hospital, 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
    Microbiology Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain)

  • Luis Martínez-Martínez

    (Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    Microbiology Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain
    Department of Agricultural Chemistry, Soil Science and Microbiology, University of Córdoba, 14004 Córdoba, Spain)

  • Inmaculada Salcedo-Leal

    (Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
    Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
    Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain)

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.

Suggested Citation

  • 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 Guz, 2022. "Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit," IJERPH, MDPI, vol. 19(3), pages 1-13, January.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:3:p:1039-:d:727286
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