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Extensively drug-resistant and multidrug-resistant gram-negative pathogens in the neurocritical intensive care unit
- Publication Year :
- 2022
- Publisher :
- SPRINGER WIEN, 2022.
-
Abstract
- Abrupt increase of multidrug-resistant, extensively drug-resistant, and pandrug-resistant bacteria may complicate the course, management, and costs of neurocritical patients and is associated with high morbidity and mortality rates. No data exists regarding risk factors for colonization by gram-negative pathogens in neurocritical patients. The aim of the study was to identify risk factors associated with colonization by multidrug-resistant, extensively drug-resistant, and pandrug-resistant gram-negative bacteria in neurocritical patients. We conducted a retrospective cohort study in a neurointensive care unit over a period of 3 years. We included adult neurocritical patients admitted for more than 48 h. We analyzed several factors including both anamnestic factors and admission diagnosis. Four hundred twenty neurocritical patients were retrospectively enrolled. Seventy-three patients developed colonization by multidrug-resistant and 53 by extensively drug-resistant gram negative pathogens. Logistic regression identified intensive care unit length of stay (LOS) as the strongest predictor for both multidrug-resistant (AUC 0.877; 95% CI 0.841–0.913) and extensively drug-resistant (AUC 0.839 0.787–0.892) gram negative pathogens. In addition, external ventricular drainage and intracerebral pressure monitoring catheter were risk factors for XDR. Survival analysis revealed that MDR bacteria colonization happens earlier (log-rank test p = 0.017). Optimization of healthcare strategies is required in order to reduce patients’ length of stay to prevent multi- and extensively-drug gram-negative colonizations. Indeed, an early external ventricular drainage and intracerebral pressure monitoring catheter removal is deemed necessary as soon as clinically appropriate.
- Subjects :
- Adult
medicine.medical_specialty
Drug resistance
030218 nuclear medicine & medical imaging
law.invention
03 medical and health sciences
0302 clinical medicine
law
Gram-Negative Bacteria
Medicine
Humans
Intensive care unit
Survival analysis
Retrospective Studies
medicine.diagnostic_test
Bacteria
business.industry
Mortality rate
Retrospective cohort study
Interventional radiology
Extensively drug resistant
Length of Stay
Infection
Multidrug resistant
Retrospective study
Risk factors
Anti-Bacterial Agents
Catheter
Intensive Care Units
Risk Factors
Emergency medicine
Surgery
Neurology (clinical)
Neurosurgery
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....7b59a0899c77b20c1d94e5cb23cd3f1a