Prognosis analysis and infection-related risk factors of multi-drug-resistant bacteria isolated from a general hospital in China, 2019-2023.

BACKGROUND

Analysis of detection trends, infection prognosis, and risk factors for nosocomial infections (NIs) in multi-drug-resistant bacteria (MDRB) can help improve infection control efforts.

METHODS

Using data from inpatients of a single-centre hospital in China from 2019 to 2023, we analysed trends of detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and meticillin-resistant Staphylococcus aureus (MRSA). The Kaplan-Meier approach was used to evaluate the survival prognosis of patients infected with resistant and sensitive K. pneumoniae, A. baumannii, P. aeruginosa and S. aureus strains. We used a 1:1 matched case-control study to analyse risk factors.

FINDINGS: The χ2 trend test indicated a statistically significant difference in the increasing rate of CRKP (χ2 = 25.481, P<0.001). CRKP and CRAB were mainly detected in the intensive care unit (ICU) and during surgery. CRPA and MRSA were mainly detected in internal medicine. The main infection sites of MDRB NI were the respiratory and blood systems. Multiple logistic regression analysis showed that patients with tumours (odds ratio (OR) = 2.886), use of corticosteroids (OR = 1.403), low albumin level (OR = 0.701), antibiotic co-administration (OR = 2.873), surgery (OR = 3.317), indwelling gastric tube (OR = 1.738), mechanical ventilation (OR = 1.616), and indwelling central venous catheterization (OR = 1.778) were independent risk variables for MDRB NI (P<0.05). A short duration of antibiotic use (OR = 0.665) was a protective factor for MDRB NI (P<0.05).

CONCLUSION

The high lethality of CRKP infections should not be ignored. Clinical work should focus on CRKP infections of the lower respiratory tract and blood system in the ICU and enhance oversight of the judicious use of antimicrobials.