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Prevalence of Multidrug-Resistant Organisms During Hospitalization and Its Association with Patient's Functional

Sara Guglielmi1, Luca Vedovelli2, Adriano Santarossa1

  • 1Azienda Unità Locale Socio-Sanitaria (AULSS) 1 Dolomiti, Belluno, Italy.

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|April 22, 2026
PubMed

Insights

Multidrug-resistant organism (MDRO) infections hinder patient functional recovery, leading to poorer outcomes. Early rehabilitation and infection control are crucial for improving patient mobility and reducing the burden of MDROs.

Area of Science:

  • Infectious Diseases
  • Rehabilitation Medicine
  • Hospital Epidemiology

Background:

  • Multidrug-resistant organisms (MDROs) pose a significant global health challenge, characterized by resistance to multiple antibiotics, leading to increased mortality and healthcare costs.
  • While the clinical consequences of MDROs are extensively documented, their impact on patients' functional recovery post-hospitalization remains an under-researched area.

Purpose of the Study:

  • To investigate the prevalence of MDRO infections within various hospital settings.
  • To analyze the association between MDRO infections and changes in patients' functional status during hospitalization.

Main Methods:

  • A retrospective cohort study involving 30,428 adult hospitalizations over four years in a Northern Italian hospital.
  • Data collected included demographics, hospitalization details, MDRO status, and Barthel Index scores at admission and discharge.
  • A multilevel linear regression model was employed to assess the impact of MDRO infection on functional status changes, controlling for relevant covariates.

Main Results:

  • MDRO infections were identified in 2.4% of hospitalizations, predominantly in medical and surgical wards, with higher rates in medical and rehabilitation units.
  • The most frequently identified MDROs were ESBL-producing Enterobacteriaceae and vancomycin-resistant enterococci.
  • Patients without MDRO infections demonstrated significantly greater improvement in Barthel Index scores compared to infected patients (+3.081, P < .001).

Conclusions:

  • MDRO infections are independently linked to diminished functional recovery, highlighting their substantial clinical and rehabilitative impact.
  • Functional gains were most pronounced in rehabilitation and neurology departments, contrasting with declines observed in medical and surgical wards.
  • Integrated strategies combining robust infection control measures with early, targeted rehabilitation are essential to mitigate the negative effects of MDROs on patient outcomes.
Keywords:
Barthel indexantimicrobial resistancefunctional statushospital-acquired infectionsmultidrug-resistant organisms

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