Mortality Risk Factors and Prognostic Analysis of Patients with Multi-Drug Resistant Infection.

BACKGROUND

The data from the China Network Antibacterial Surveillance Center (http://www.chinets.com) showed that the prevalence of (), (KP), and (ecl), was 18.96%, 14.12%, and 2.74% in 2022, respectively. The resistance rates of and KP to 3rd or 4th generation cephalosporins were 51.7% and 22.1%, to carbapenems was 1.7% and 3.9%, to quinolones was 55.9% in Shanxi. The generation of extended-spectrum beta-lactamases (ESBLs) is a major mechanism resulting in drug resistance in . To determine the mortality risk factors of multi-drug resistant (MDRE) and multi-drug resistant (MDR-KP) infection.

METHODS

91 MDR strains from 91 patients were collected from 2015 to 2019 in the second hospital of Shanxi Medical University. The mortality risk factors for the MDRE infections and clinical outcomes were analyzed by univariable and multivariable analysis. The independent predictors of 30-day mortality were analyzed through the Cox regression analysis including the variables with a value <0.2.

RESULTS

The majority of patients were admitted to ICUs. Pulmonary infection was a major infection (43.96%, 40/91). Thirty-three (36.26%, 33/91) strains of MDR-KP were only detected in 2018. The proportion of multi-drug resistant (MDR ) and multi-drug resistant (MDR ecl) were 16.48% (15/91) and 17.58% (16/91), respectively. The presence of cerebrovascular diseases (OR, 4.046; 95%Cl, 1.434-11.418; P=0.008) and central venous catheterization (OR, 4.543; 95%Cl, 1.338-15.425; P=0.015) were associated with mortality in patients with MDRE infections. Endotracheal intubation (OR, 4.654; 95%Cl, 1.5-14.438; P=0.008) was an independent mortality risk factor for patients infected with MDR-KP strains. Patients who received aminoglycoside antibiotics (P=0.057) had a higher 30-day survival rate. The β-lactam antibiotics were the major agent in the clinic.

CONCLUSION

This study implies that patients with cerebrovascular diseases, central venous catheterization, and endotracheal intubation are at risk of carrying MDR isolates.