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Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
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Burden, risk factors, and outcomes of multidrug-resistant bacterial colonisation at multiple sites in patients with

Nipun Verma1, P Venkata Divakar Reddy2, Shashi Vig3

  • 1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

JHEP Reports : Innovation in Hepatology
|July 24, 2023
PubMed
Abstract

Insights

Multidrug-resistant organism (MDRO) colonization is common in Indian patients with cirrhosis. Multiple colonization sites significantly increase the risk of MDRO infections, organ failure, and mortality.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Multidrug-resistant organism (MDRO) infections pose a significant threat, particularly in patients with cirrhosis.
  • India reports a high burden of MDRO infections among cirrhosis patients, necessitating investigation into colonization patterns.

Purpose of the Study:

  • To evaluate if colonization at multiple body sites predisposes cirrhosis patients to MDRO infections and poor outcomes.
  • To identify risk factors associated with MDRO colonization in patients with cirrhosis.

Main Methods:

  • Prospective study involving swab cultures, antimicrobial susceptibility testing (AST), and genotype testing for MDROs from various sites (rectum, nose, skin, central line).
  • Analysis of clinical data, risk factors for MDRO colonization, and patient outcomes (infections, organ failure, survival) in cirrhosis patients.
  • Conducted between 2020-2021 at a tertiary institute, including admission and follow-up assessments.

Main Results:

  • 79.2% of 125 cirrhosis patients were identified as 'colonizers' for MDROs.
  • High colonization rates observed at the rectum (72.7%), nose (30.0%), and skin (14.9%). Common MDROs included extended-spectrum beta-lactamase producers and carbapenem-resistant Enterobacterales.
  • Multiple-site colonization (30% of patients) was independently associated with increased risk of MDRO infection (OR: 7.9), multi-organ failure, and poorer 30-day survival (HR: 2.0).

Conclusions:

  • A high prevalence of MDRO colonization exists in Indian patients with cirrhosis, demanding urgent control strategies.
  • Colonization at multiple body sites significantly elevates the risk of developing MDRO infections, multi-organ failure, and mortality in this vulnerable population.
Keywords:
Antimicrobial resistanceCirrhosisMDRMortalityOne health

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