%0 Journal Article
%A Fernandez-Martinez, Nicolas Francisco
%A Carcel-Fernandez, Sheila
%A De la Fuente-Martos, Carmen
%A Ruiz-Montero, Rafael
%A Guzman-Herrador, Bernardo R
%A Leon-Lopez, Rafael
%A Gomez, Francisco Javier
%A Guzman-Puche, Julia
%A Martinez-Martinez, Luis
%A Salcedo-Leal, Inmaculada
%T Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit.
%D 2022
%U http://hdl.handle.net/10668/21018
%X Multidrug-resistant Gram-negative bacteria (MDR-GNB) are microorganisms that have acquired resistance to extended-spectrum antibacterials and constitute an emerging threat to public health. Although carriers are an important source of transmission in healthcare settings, data about risk factors for MDR-GNB carriage are limited. Therefore, we aimed to identify risk factors for MDR-GNB carriage upon intensive care unit (ICU) admission and to optimise screening strategies. We conducted a case-control study. Admissions of adult patients to the ICU of a 1000-bed hospital during a year were included. We collected sociodemographic, clinical and microbiological data and performed a multivariate logistic regression model. A total of 1342 patients resulted in 1476 episodes of ICU admission, 91 (6.2%) of whom harboured MDR-GNB (38.5% women; median age 63.9 years). The most frequently isolated pathogens were Escherichia coli (57%) and Klebsiella pneumoniae (16%). The most frequent resistance mechanism was production of extended-spectrum beta lactamases. MDR-GNB carriage was associated to liver cirrhosis (OR 6.54, 95% CI 2.17-19.17), previous MDR-GNB carriage (OR 5.34, 1.55-16.60), digestive surgery (OR 2.83, 1.29-5.89) and length of hospital stay (OR 1.01 per day, 1.00-1.03). Several risk factors for MDR-GNB carriage upon admission to a high-risk setting were identified; the main comorbidity was liver cirrhosis.
%K Antibacterial drug resistance
%K Critical care
%K Epidemiology
%K Gram negative bacteria
%K Infection control
%K Risk factors
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