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RESEARCH PRODUCT
Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey
Recep TekinHaluk VahabolguIrina Magdalena DumitruJordi RelloSvjetlana GrgićDhruv MamtoraMichael M. PetrovFatma A. AmerYesim Uygun-kizmazHandan AlayMonica LickerDeana MedicRosa Fontana Del VecchioAnna LiskovaYasemin CagNefise OztoprakPhunsup WongsurakiatAbdullah Umut PekokAliye EsmaoğluNirav PandyaRusmir BaljicMustafa DoganKrsto GrozdanovskiEmine Unal EvrenGorana DragovacAhsen OnculSerhat UysalJurica ArapovićJurica ArapovićRicardo FernandezYesim KurekciLul RakaBehrouz NaghiliAmani El-kholyNenad PandakNatalia DiraniMehmet ÖZdemirIlad Alavi DarazamBiljana CarevicAndrea MarinoMaha Ali GadCaroline LandelleRavina KullarEgidia MiftodeEjaz Ahmed KhanNicolas DaubyJehan El KholyIonela Larisa MiftodeHema Prakash Kumari PilliLurdes SantosReham KhedrGoffredo AngioniSzabo Balint GergelyRidvan KaraaliAntonio CascioNasim AkhtarMostafa KamalAndré Silva-pintoMumtaz Ali KhanRehab H. El-sokkaryŞAfak ÖZer BalinHakan ErdemRami Alabadlasubject
Male0301 basic medicineKlebsiella pneumoniaeDrug ResistanceInfection controlMultidrug resistance0302 clinical medicineMedical microbiologyDrug Resistance Multiple Bacterial80 and overInfection controlMedicine030212 general & internal medicineChildAged 80 and overCross InfectionbiologyMicrobial Sensitivity TestBacterialBacterial InfectionsGeneral MedicineMiddle AgedSciences bio-médicales et agricolesCountriesAnti-Bacterial AgentsAcinetobacter baumanniiEuropeIntensive Care UnitsInfectious DiseasesChild PreschoolFemaleMultipleMicrobiology (medical)Adultmedicine.medical_specialtyAdolescent030106 microbiologyIntensive Care UnitPan-drug resistanceMicrobial Sensitivity TestsInfectionsBacterial InfectionYoung Adult03 medical and health sciencesAntibiotic resistanceIntensive careInternal medicineAnti-Bacterial AgentHumansStewardshipXDRPreschoolAgedCross-Sectional StudieBacteriabusiness.industryInfantbiology.organism_classificationmedicine.diseaseMultiple drug resistanceCross-Sectional StudiesBacteremiabusinessLow- and upper-middle and high incomedescription
Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-06-21 |