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Published on: August 30, 2018
Meta-analysis of risk factors for infection by multi-drug-resistant organisms in intensive care unit patients
1West China School of Nursing, Sichuan University/Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China; Institute of Disaster Medicine, Sichuan University, Chengdu, China; Nursing Key Laboratory of Sichuan Province, Chengdu, China.
Background:
Patients with infection by multi-drug-resistant organisms (MDROs) are often complicated, difficult to cure, require advanced antimicrobial drugs for treatment, and are susceptible to bacterial colonization. This places a heavy economic burden on patients, which can even lead to death, and also increases the economic burden on healthcare services.
Aim:
We aimed to systematically assess the risk factors for infection by MDROs in patients in the intensive care unit (ICU).
Methods:
PubMed, Embase, MEDLINE, and the Cochrane Library were queried from database inception to 21st September 2023, for literature on risk factors for MDRO infection in patients in the ICU. Two researchers independently performed the screening, data extraction, and quality assessment of the retrieved articles. Data were statistically analysed using Stata 16.0.
Findings:
This meta-analysis included 29 articles involving 18,063 patients, of whom 2955 had contracted MDRO infections. The results of the meta-analysis revealed that diabetes mellitus, cardiovascular disease, history of hospitalization within the previous year, abnormal liver function, history of MDRO infection, injury severity score, length of ICU stay, nasogastric tube, parenteral nutrition, colonization pressure, multiple traumas, mechanical ventilation, tracheostomy, central venous catheter, previous antibiotic treatment, immunosuppressive agents, piperacillin-tazobactam, multi-antibiotic treatment, glycopeptide antibiotics, carbapenems, imipenem, and nitroimidazoles were risk factors for MDRO infection in patients in the ICU.
Conclusions:
The ICU is a high-risk area for MDRO infection. Healthcare professionals should adopt prevention and control measures based on these risk factors to reduce the occurrence of MDRO infections.
Insights
Multi-drug-resistant organism (MDRO) infections in the ICU are a significant concern. Key risk factors include diabetes, cardiovascular disease, and prior hospitalization, necessitating targeted prevention strategies.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Patients with multi-drug-resistant organism (MDRO) infections face complex treatment challenges and increased mortality.
- MDRO infections impose substantial economic burdens on both patients and healthcare systems.
- Bacterial colonization is a common complication in patients susceptible to MDROs.
Purpose of the Study:
- To systematically identify and assess the risk factors associated with MDRO infections in intensive care unit (ICU) patients.
- To provide evidence-based insights for preventing and controlling MDRO infections in critical care settings.
Main Methods:
- A comprehensive meta-analysis was conducted, searching major medical databases (PubMed, Embase, MEDLINE, Cochrane Library) up to September 21, 2023.
- Two independent researchers performed article screening, data extraction, and quality assessment.
- Statistical analysis was performed using Stata 16.0 on data from 29 included studies.
Main Results:
- The meta-analysis included 29 articles with 18,063 patients, of whom 2955 had MDRO infections.
- Identified risk factors for MDRO infection in the ICU include: diabetes mellitus, cardiovascular disease, prior hospitalization, abnormal liver function, previous MDRO infection, high injury severity score, prolonged ICU stay, invasive devices (nasogastric tube, central venous catheter), parenteral nutrition, and immunosuppressive agents.
- Antibiotic-related factors such as previous antibiotic treatment, multi-antibiotic regimens, and specific antibiotic classes (piperacillin-tazobactam, glycopeptides, carbapenems, imipenem, nitroimidazoles) were also significant risk factors.
Conclusions:
- The intensive care unit (ICU) is a high-risk environment for the development of MDRO infections.
- Healthcare professionals must implement targeted prevention and control measures by addressing identified risk factors.
- Reducing the incidence of MDRO infections in ICUs requires a proactive approach based on clinical evidence.
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