{"title":"Meta-analysis of risk factors for infection by multi-drug-resistant organisms in intensive care unit patients","authors":"Q. Ye , X. Chen , J. Zhang , J. Lin","doi":"10.1016/j.jhin.2025.01.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Patients with infection by multi-drug-resistant organisms (MDROs) are often complicated, difficult to cure, require advanced antimicrobial drugs for treatment, and are susceptible to bacterial colonization. This places a heavy economic burden on patients, which can even lead to death, and also increases the economic burden on healthcare services.</div></div><div><h3>Aim</h3><div>We aimed to systematically assess the risk factors for infection by MDROs in patients in the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>PubMed, Embase, MEDLINE, and the Cochrane Library were queried from database inception to 21<sup>st</sup> September 2023, for literature on risk factors for MDRO infection in patients in the ICU. Two researchers independently performed the screening, data extraction, and quality assessment of the retrieved articles. Data were statistically analysed using Stata 16.0.</div></div><div><h3>Findings</h3><div>This meta-analysis included 29 articles involving 18,063 patients, of whom 2955 had contracted MDRO infections. The results of the meta-analysis revealed that diabetes mellitus, cardiovascular disease, history of hospitalization within the previous year, abnormal liver function, history of MDRO infection, injury severity score, length of ICU stay, nasogastric tube, parenteral nutrition, colonization pressure, multiple traumas, mechanical ventilation, tracheostomy, central venous catheter, previous antibiotic treatment, immunosuppressive agents, piperacillin-tazobactam, multi-antibiotic treatment, glycopeptide antibiotics, carbapenems, imipenem, and nitroimidazoles were risk factors for MDRO infection in patients in the ICU.</div></div><div><h3>Conclusions</h3><div>The ICU is a high-risk area for MDRO infection. Healthcare professionals should adopt prevention and control measures based on these risk factors to reduce the occurrence of MDRO infections.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"158 ","pages":"Pages 1-10"},"PeriodicalIF":3.1000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670125000295","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Patients with infection by multi-drug-resistant organisms (MDROs) are often complicated, difficult to cure, require advanced antimicrobial drugs for treatment, and are susceptible to bacterial colonization. This places a heavy economic burden on patients, which can even lead to death, and also increases the economic burden on healthcare services.
Aim
We aimed to systematically assess the risk factors for infection by MDROs in patients in the intensive care unit (ICU).
Methods
PubMed, Embase, MEDLINE, and the Cochrane Library were queried from database inception to 21st September 2023, for literature on risk factors for MDRO infection in patients in the ICU. Two researchers independently performed the screening, data extraction, and quality assessment of the retrieved articles. Data were statistically analysed using Stata 16.0.
Findings
This meta-analysis included 29 articles involving 18,063 patients, of whom 2955 had contracted MDRO infections. The results of the meta-analysis revealed that diabetes mellitus, cardiovascular disease, history of hospitalization within the previous year, abnormal liver function, history of MDRO infection, injury severity score, length of ICU stay, nasogastric tube, parenteral nutrition, colonization pressure, multiple traumas, mechanical ventilation, tracheostomy, central venous catheter, previous antibiotic treatment, immunosuppressive agents, piperacillin-tazobactam, multi-antibiotic treatment, glycopeptide antibiotics, carbapenems, imipenem, and nitroimidazoles were risk factors for MDRO infection in patients in the ICU.
Conclusions
The ICU is a high-risk area for MDRO infection. Healthcare professionals should adopt prevention and control measures based on these risk factors to reduce the occurrence of MDRO infections.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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