Rectal colonization with multidrug-resistant organisms and risk for bloodstream infection among high-risk Greek patients.

BACKGROUND

Studies link multidrug-resistant organism (MDRO) rectal colonization to increased infection risk, data from Greece, a country with high rates of MDRO, are limited.

METHODS

We assessed bloodstream infection (BSI) risk following rectal colonization by MDROs across three Greek hospitals (2019-2022).

RESULTS

Of 4,370 inpatients, 31.1% were colonized by carbapenem-resistant Enterobacterales (CRE), 30.1% carbapenem-resistant Acinetobacter baumannii (CRAB), 5.8% carbapenem-resistant Pseudomonas aeruginosa (CRPA), 28.4% vancomycin-resistant enterococci (VRE). Subsequent BSI from the same MDRO species was developed in 15.6% of CRE, 19.7% of CRAB, 9.2% of CRPA and 3.5% of VRE carriers. Previous rectal colonization increases significantly MDRO BSI risk [RR (95%CI): CRE 5.2 (3.9-6.8), CRAB 2.7 (2.2-3.3), CRPA 9.6 (5.8-16.0), VRE 2.5 (1.5-4.2)].

CONCLUSION

Clinicians should consider MDRO carriage information for selecting empiric treatment.