Differential Profiles of intensive care unit multidrug-resistant patients: Influence of prior antibiotic therapy on clinical features.

Abstract

Objectives: To study the characteristics and their influence on outcomes of ICU patients with multi drug resistant infections with and without prior antibiotic use before admission.

Methods: This single center study included 365 patients admitted to Medical and Surgical ICUs of KRL Hospital, Islamabad, from January 2023 to January 2024, who acquired a multi drug resistant infection 48 hours post-admission to the ICU. This was an observational study and purposive sampling was done. Kolmogorov-Smirnov test was employed to test the normality of data. The chi-square test was used to observe the association between categorical variables. The Mann-Whitney U test was used for continuous variables. Multivariate analysis was employed to compare the effect of different parameters on mortality.

Results: A total of 365 patients were included. The mean age was 62.2 ± 17.1, (<65 years = 54.2% and >65 years = 45.8%) with 185 (50.7%) males. Males, diabetics, those with chronic kidney disease, DCLD, CVA, hospitalization in last 6 months had a greater frequency of prior antibiotic exposure. Similarly, this group also showed increased frequency of thrombocytopenia and prolonged ICU stay than those with no previous antibiotic exposure. Longer duration of indwelling lines, hospital stay, ICU stay and Mechanical ventilation was associated with increased mortality.

Conclusion: Previous antibiotic use is linked to longer ICU and hospital stays, extended use of indwelling lines, and increased duration of mechanical ventilation, all of which contribute to greater financial burdens. However, there was no significant difference in mortality between the antibiotic and non-antibiotic groups. Further studies conducted on a larger scale across multiple ICUs could provide deeper insights into this relationship.