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Risk Factors for Colonization With Multidrug-Resistant Bacteria Among Patients Admitted to the Intensive Care Unit

Marion Angue1, Nicolas Allou1, Olivier Belmonte2

  • 1Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France.

Journal of Travel Medicine
|June 18, 2015
PubMed
Abstract

Insights

Patients returning from abroad, especially those hospitalized and treated with antibiotics, have a higher risk of carrying multidrug-resistant (MDR) bacteria. Screening these travelers is recommended to prevent ICU infections.

Area of Science:

  • Infectious Diseases
  • Intensive Care Medicine
  • Microbiology

Background:

  • Limited national guidelines exist for managing patients returning from abroad, particularly for non-hospitalized individuals.
  • Focus has been on hospitalized patients, leaving a gap in understanding risks for those admitted to intensive care units (ICUs).

Purpose of the Study:

  • To compare the prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in ICU patients with recent stays abroad versus local patients.
  • To identify specific risk factors for MDR bacteria carriage among patients with a history of travel abroad.

Main Methods:

  • Retrospective chart review of 1,842 ICU patients from January 2011 to July 2013.
  • Identification of patients with stays abroad within six months prior to ICU admission.
  • Analysis of hygiene sampling data to determine MDR bacteria carriage and acquisition rates.

Main Results:

  • 7% of ICU patients (129/1,842) had stayed abroad.
  • The 'Abroad' group showed significantly higher MDR bacteria carriage at admission (33% vs. 6.7%) and acquisition during ICU stay (17% vs. 5.2%) compared to 'Local' patients.
  • Key risk factors for MDR carriage in 'Abroad' patients included diabetes mellitus (OR 5.1) and hospitalization abroad with antibiotic treatment (OR 10.7).

Conclusions:

  • Hospitalization abroad, particularly with antibiotic treatment, is a significant risk factor for MDR bacteria carriage in ICU patients.
  • Screening and isolation of patients returning from abroad are recommended, even with initial negative screenings.
  • This highlights the importance of considering travel history in infection control protocols for ICU patients.

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