First multicenter study on multidrug resistant bacteria carriage in Chinese ICUs

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• The prevalence and impact of multidrug-resistant organisms (MDRO) in Chinese hospitals remain underexplored.
• Intensive care units (ICUs) are critical settings for monitoring MDRO emergence due to vulnerable patient populations.

Purpose of the Study:

• To determine the prevalence of MDRO among patients admitted to ICUs in China.
• To identify factors associated with MDRO carriage on admission and acquisition during ICU stay.

Main Methods:

• A prospective study involving 686 inpatients across eight ICUs in four Chinese cities (2009-2010).
• Screening for methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Enterobacteriaceae, Acinetobacter, and Pseudomonas aeruginosa.
• Logistic regression models were used to analyze factors associated with MDRO carriage and acquisition.

Main Results:

• MDRO prevalence on ICU admission was 30.5%, with extended-spectrum beta-lactamase-producing Enterobacteriaceae being most common (32.7%).
• Over 23% of patients acquired at least one MDRO during their ICU stay, with acquisition rates increasing with longer duration of stay.
• Antibiotic treatment prior to ICU admission and duration of antibiotic exposure were significant factors for MDRO acquisition.

Conclusions:

• Over half of patients (51.2%) were MDRO carriers upon ICU discharge in Chinese hospitals.
• High MDRO prevalence on admission combined with significant acquisition rates within ICUs contribute to the overall burden.
• Findings underscore the need for enhanced infection control strategies in Chinese ICUs to combat MDRO spread.