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Published on: August 30, 2018
The Prevalence of Multidrug-Resistant and Extensively Drug-Resistant Infections in Respiratory Intensive Care Unit,
Kamuran Uluç1, Hatice Kutbay Özçelik2, Esra Akkütük Öngel2
1Department of Intensive Care, Muş State Hospital, Muş, Turkey.
Aim:
This study aims to analyze the incidence of multidrug-resistant (MDR) retrospectively and extensively drug-resistant (XDR) infections, characteristics of patients with these infections, causative microorganisms, and mortality rates in a tertiary respiratory intensive care unit (ICU).
Material And Method:
Between 01.01.2022 and 31.12.2023, the data of patients treated in the third-level respiratory ICU were analyzed retrospectively. Adult patients over 18 years of age with MDR and XDR infections were included in the study. Demographic characteristics, age, gender, comorbid systemic diseases, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilation support status, duration of ICU stay and prognosis of the patients were analyzed and recorded through the hospital information management system.
Results:
The study included 261 patients. Of these patients, 184 (70.5%) were male, 77 (29.5%) were female, and their ages were 65.54 ± 14.43 years. The majority of the patients had chronic diseases such as chronic obstructive pulmonary disease, hypertension, coronary artery disease, malignancy, and diabetes mellitus. There was no statistically significant difference between the resistance status of Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. and the prognosis of the patients (p>0.05). No statistically significant difference was found between MDR and XDR Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. patients in terms of the need for invasive mechanical ventilation, non-invasive mechanical ventilation, respiratory support therapy with high flow, APACHE II score, SOFA score, length of stay in the ICU, and prognosis (p>0.05).
Conclusion:
Early detection and close monitoring of MDR, XDR, and PDR bacterial strains are vital to combat antimicrobial resistance. This study shows that MDR and XDR infections are a major health problem in ICUs and that these infections have significant negative effects on patient prognosis.
Insights
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) infections pose a significant threat in intensive care units (ICUs), negatively impacting patient outcomes. Early detection and monitoring are crucial for combating antimicrobial resistance.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Antimicrobial resistance is a growing global health concern, particularly in intensive care units (ICUs).
- Multidrug-resistant (MDR) and extensively drug-resistant (XDR) infections are associated with increased morbidity and mortality.
- Effective strategies for managing these resistant infections are urgently needed.
Purpose of the Study:
- To retrospectively analyze the incidence of MDR and XDR infections in a tertiary respiratory ICU.
- To characterize patients with these infections, including demographics, comorbidities, and severity scores.
- To identify causative microorganisms and assess mortality rates associated with MDR and XDR infections.
Main Methods:
- Retrospective analysis of patient data from a tertiary respiratory ICU between January 2022 and December 2023.
- Inclusion of adult patients (over 18) diagnosed with MDR or XDR infections.
- Collection of data on patient demographics, comorbidities, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, Sequential Organ Failure Assessment (SOFA) scores, mechanical ventilation status, ICU stay duration, and prognosis.
Main Results:
- The study included 261 patients, with 70.5% being male and an average age of 65.54 years.
- Common comorbidities included chronic obstructive pulmonary disease, hypertension, coronary artery disease, malignancy, and diabetes mellitus.
- No statistically significant differences were found in prognosis or clinical outcomes between MDR and XDR infections caused by Klebsiella spp., Pseudomonas spp., and Acinetobacter spp.
Conclusions:
- MDR and XDR infections represent a substantial challenge in ICUs, significantly impacting patient prognosis.
- Close monitoring and early detection of resistant bacterial strains are vital for effective antimicrobial stewardship.
- Further research is needed to develop targeted interventions to improve outcomes for patients with these severe infections.
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