Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Association of Multidrug Resistance Bacteria and Clinical Outcomes of Adult Patients with Sepsis in the Intensive Care Unit

Version 1 : Received: 21 September 2022 / Approved: 21 September 2022 / Online: 21 September 2022 (10:45:23 CEST)

How to cite: Al-Sunaidar, K.A.; Aziz, N.A.; Hassan, Y.; Jamshed, S.; Sekar, M. Association of Multidrug Resistance Bacteria and Clinical Outcomes of Adult Patients with Sepsis in the Intensive Care Unit. Preprints 2022, 2022090326 (doi: 10.20944/preprints202209.0326.v1). Al-Sunaidar, K.A.; Aziz, N.A.; Hassan, Y.; Jamshed, S.; Sekar, M. Association of Multidrug Resistance Bacteria and Clinical Outcomes of Adult Patients with Sepsis in the Intensive Care Unit. Preprints 2022, 2022090326 (doi: 10.20944/preprints202209.0326.v1).

Abstract

Background: Multi-drug resistance organisms (MDRO) often cause increased morbidity, mortality, and length of stays (LOS). However, there is uncertainty whether the infection of MDRO increase the morbidity, mortality, and ICU-LOS. Objective: This study performed to determine the prevalence of MDRO in ICU, site of infection and the association of MDRO or site of infection with mortality. Secondary outcome was determined by ascertaining the association of MDRO or site of infection with (ICU-LOS). Methods: A retrospective cohort study was performed with adult sepsis patients in ICU. Univariate and multivariate (MVA) logistic regression with cox regression modeling were performed to compute the association of MDRO on ICU-mortality. MVA modelling was performed for ICU-LOS predictors. Results: Out of 228 patients, the isolated MDRO was 97 (42.5%) of which 78% were gram-negative bacteria. The mortality rate among those with MDRO was 85 (37.3%). The hospital acquired infection (HAI) was significantly predictor for ICU-LOS in univariate linear regression (R² = 0.034, P=0.005). In MVA linear regression, both Enterococcus faecalis infection and acinetobacter baumannii (AC) -MDRO were predictors for ICU-LOS with (R² = 0.478, P<0.05). In the univariate cox regression, only the infection with AC- MDRO was a risk factor for ICU-mortality with [ HR =1.802 (95% CI: 1.2 – 2.706; P = 0.005)]. Conclusions: Identifying risk factors for MDRO highlight the appropriate administration of empirical antibiotics and effectively control of source of infection which would reduce mortality and ICU-LOS. The usage of broad- spectrum antibiotics should be limited for those having substantial risk factors to acquire MDRO.

Keywords

multidrug resistance organism; sepsis; adequate empirical antibiotics; source of infection; APACHE II; ICU length stay; predictors; risk factors; mortality

Subject

MEDICINE & PHARMACOLOGY, Other

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