Fernandez-Martinez, Nicolas FranciscoCarcel-Fernandez, SheilaDe la Fuente-Martos, CarmenRuiz-Montero, RafaelGuzman-Herrador, Bernardo RLeon-Lopez, RafaelGomez, Francisco JavierGuzman-Puche, JuliaMartinez-Martinez, LuisSalcedo-Leal, Inmaculada2023-05-032023-05-032022-01-15Fernández-Martínez NF, Cárcel-Fernández S, De la Fuente-Martos C, Ruiz-Montero R, Guzmán-Herrador BR, León-López R, et al. Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit. Int J Environ Res Public Health. 2022 Jan 18;19(3):1039http://hdl.handle.net/10668/21018Multidrug-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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Antibacterial drug resistanceCritical careEpidemiologyGram negative bacteriaInfection controlRisk factorsAdultAnti-bacterial agentsCase-control studiesCross infectionDrug resistance, multiple, bacterialFemaleGram-negative bacteriaGram-negative bacterial infectionsHumansIntensive care unitsMaleMiddle agedRisk factorsResearch article35162062open accessAntibacterianosBacterias gramnegativasFarmacorresistencia bacteriana múltipleInfecciones por bacterias gramnegativasInfección hospitalariaUnidades de cuidados intensivos10.3390/ijerph190310391660-4601PMC8834020https://www.mdpi.com/1660-4601/19/3/1039/pdf?version=1642500819https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834020/pdf