Risk Factors and Antibiotic Utilization Patterns in Multidrug-Resistant Surgical Infections: A Retrospective Study...

Area of Science:

• Infectious Diseases
• Surgical Infections
• Antimicrobial Resistance

Background:

• Multidrug-resistant (MDR) infections pose a significant threat to surgical patients, especially those with extended hospital stays and intensive care unit (ICU) exposure.
• Identifying risk factors for MDR infections and their impact on mortality is crucial for effective antimicrobial stewardship and infection control.

Purpose of the Study:

• To identify independent predictors of multidrug-resistant (MDR) infections in surgical patients.
• To determine the association between MDR infections and in-hospital mortality.
• To analyze antibiotic utilization patterns in surgical patients with and without MDR infections.

Main Methods:

• Retrospective observational study of surgical patients in a Romanian tertiary-care hospital (2020-2022).
• Analysis of demographic, clinical, microbiological, and antibiotic utilization data.
• Multivariate logistic regression and ROC curve analysis were employed to identify risk factors and mortality predictors.

Main Results:

• Prolonged ICU stay and hospitalization were key predictors of MDR infection.
• MDR infections were significantly associated with increased in-hospital mortality, alongside ICU stay and older age.
• MDR cases showed higher use of broad-spectrum antibiotics, while non-MDR cases used narrower regimens. Common MDR pathogens included *Klebsiella pneumoniae*, *Pseudomonas aeruginosa*, and *Acinetobacter baumannii*.

Conclusions:

• Prolonged healthcare exposure, particularly ICU admission and extended hospitalization, drives MDR infections in surgical patients.
• Targeted infection control and optimized antimicrobial use are essential to reduce mortality and combat resistance spread.