High Acquisition Rate of Gram-Negative Multi-Drug Resistant Organism Colonization During Hospitalization: A Perspective from a High Endemic Setting

Bayaraa Baljin,1 Ulziijargal Gurjav,1 Khosbayar Tulgaa,2 Ganbaatar Baldan,1 Batbaatar Gunchin,3 Tsogtsaikhan Sandag,3 Klaus Pfeffer,4 Andreas F Wendel,5 Colin R MacKenzie4 1Department of Microbiology, Infection Prevention and Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; 2Department of Molecular Biology and Genetics, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; 3Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; 4Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany; 5Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, Cologne, GermanyCorrespondence: Bayaraa BaljinDepartment of Microbiology, Infection Prevention and Control, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaEmail bayaraa@mnums.edu.mnObjective: The aim of the study was to compare the rate of gram-negative multi-drug resistant organism (GN-MDRO) colonization at admission and during hospitalization and to describe the strains and antibiotic resistance genes acquired during hospitalization.Methods: Rectal swabs were collected from patients hospitalized at the National Trauma Center (NTC), Mongolia, at the time of admission and after 14 days of hospitalization as has been detailed on our previous study. GN-MDRO antibiotic resistance was determined using EUCAST standards, and resistance genes were detected using multiplex PCR.Results: A total of 158 patients were screened, and baseline colonization rate at admission was 29.1% (46/158). The rate went up to 69.9% (110/158) after 14 days of hospitalization (p< 0.001). Of all participants, 74 patients (46.8%) screened GN-MDRO negative at admission acquired colonization by day 14. Other 36 patients (22.8%) maint