The Prevalence of Multidrug-Resistant and Extensively Drug-Resistant Infections in Respiratory Intensive Care Unit, Causative Microorganisms and Mortality.

Abstract

Aim: This study aims to analyze the incidence of multidrug-resistant (MDR) retrospectively and extensively drug-resistant (XDR) infections, characteristics of patients with these infections, causative microorganisms, and mortality rates in a tertiary respiratory intensive care unit (ICU).

Material and method: Between 01.01.2022 and 31.12.2023, the data of patients treated in the third-level respiratory ICU were analyzed retrospectively. Adult patients over 18 years of age with MDR and XDR infections were included in the study. Demographic characteristics, age, gender, comorbid systemic diseases, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilation support status, duration of ICU stay and prognosis of the patients were analyzed and recorded through the hospital information management system.

Results: The study included 261 patients. Of these patients, 184 (70.5%) were male, 77 (29.5%) were female, and their ages were 65.54 ± 14.43 years. The majority of the patients had chronic diseases such as chronic obstructive pulmonary disease, hypertension, coronary artery disease, malignancy, and diabetes mellitus. There was no statistically significant difference between the resistance status of Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. and the prognosis of the patients (p>0.05). No statistically significant difference was found between MDR and XDR Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. patients in terms of the need for invasive mechanical ventilation, non-invasive mechanical ventilation, respiratory support therapy with high flow, APACHE II score, SOFA score, length of stay in the ICU, and prognosis (p>0.05).

Conclusion: Early detection and close monitoring of MDR, XDR, and PDR bacterial strains are vital to combat antimicrobial resistance. This study shows that MDR and XDR infections are a major health problem in ICUs and that these infections have significant negative effects on patient prognosis.