Infection and drug resistance · 2026
Risk Factors and Medical Burden of Multidrug-Resistant Organism Infection in Hospitalized Patients with Pneumonia.
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Dai Jing, Xing Yingru, Zhong Jiabao, Zhu Linying, Wang Haizhou, Dai Zhuangqing, Yu Shoukai, Ma Xiaoting, Wu Hao
Аннотация
INTRODUCTION: Multi-drug resistant organism (MDRO) infections represent a global public health challenge. Patients hospitalized with pneumonia are prone to secondary MDRO infections, which can lead to poor prognosis, significantly prolong hospital stays, and increase medical and economic burdens.
METHODS: This single‑center retrospective cohort study conducted at a tertiary hospital in Shanghai, China aimed to identify risk factors for MDRO infection and assess its hospitalization‑related burden, and to construct a predictive nomogram. A total of 1686 patients with pneumonia were enrolled. The data were analyzed through 1:2 manual matching. Logistic regression was used to screen independent risk factors for multidrug‑resistant organism (MDRO) infections; Generalized Linear Models (GLMs) were employed to quantify the increase in hospital stay and medical expenses caused by MDROs. A predictive nomogram was constructed and validated using ROC curves and calibration curves.
RESULTS: A total of 676 multidrug-resistant bacteria (MDRO) strains required for the study were isolated. Among them, carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the majority, reaching 30.03% (203/676). Compared with controls, the MDRO group had markedly longer hospital stay (median 20.00 vs 9.00 days, P<0.001) and substantially higher hospitalization costs, with a 3.6‑fold higher median cost. GLM confirmed MDRO infection independently aggravated hospitalization burden. Six independent risk factors were determined. The nomogram achieved an AUC of 0.817 with good calibration and reliable predictive efficacy.
CONCLUSION: MDRO infection substantially raises hospitalization burdens for pneumonia patients. The risk factors and validated nomogram can guide targeted hospital-based MDRO prevention and intervention.
METHODS: This single‑center retrospective cohort study conducted at a tertiary hospital in Shanghai, China aimed to identify risk factors for MDRO infection and assess its hospitalization‑related burden, and to construct a predictive nomogram. A total of 1686 patients with pneumonia were enrolled. The data were analyzed through 1:2 manual matching. Logistic regression was used to screen independent risk factors for multidrug‑resistant organism (MDRO) infections; Generalized Linear Models (GLMs) were employed to quantify the increase in hospital stay and medical expenses caused by MDROs. A predictive nomogram was constructed and validated using ROC curves and calibration curves.
RESULTS: A total of 676 multidrug-resistant bacteria (MDRO) strains required for the study were isolated. Among them, carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the majority, reaching 30.03% (203/676). Compared with controls, the MDRO group had markedly longer hospital stay (median 20.00 vs 9.00 days, P<0.001) and substantially higher hospitalization costs, with a 3.6‑fold higher median cost. GLM confirmed MDRO infection independently aggravated hospitalization burden. Six independent risk factors were determined. The nomogram achieved an AUC of 0.817 with good calibration and reliable predictive efficacy.
CONCLUSION: MDRO infection substantially raises hospitalization burdens for pneumonia patients. The risk factors and validated nomogram can guide targeted hospital-based MDRO prevention and intervention.