J Acute Care Surg.  2017 Apr;7(1):9-14. 10.17479/jacs.2017.7.1.9.

Prevalence of Multidrug Resistant Organisms in Inter-Hospital Transferred Critically Ill Patients

• Heo C
• Lee DS
• Gil E
• Park CM

• KMID: 2384010
• DOI: http://doi.org/10.17479/jacs.2017.7.1.9

Abstract

PURPOSE
To assess the prevalence of multidrug-resistant organisms (MDROs) in inter-hospital transferred critically ill patients.
METHODS
This is a retrospective study. The study population comprised patients who were transferred from other hospitals or health care units into the medical or surgical intensive care unit of Samsung Medical Center from January 2012 to December 2014. We evaluated the acquisition of clinically significant MDROs including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria, and carbapenem- resistant Gram-negative bacteria (CRGNB).
RESULTS
Three hundred and twenty-one patients were included in this study. One hundred and fifty-one patients (47.0%) had at least one species of MDRO, 21.5% in MRSA, 27.1% in VRE, 15.6% in CRGNB, and 3.7% in ESBL. The prevalence of MDROs was significantly higher in male (52.7%), patients with diabetes (61.6%), patients with combined infectious diseases (51.6%), and medical patients (49.3%). Patients with MRSA had significantly longer length of stay than the patients without MRSA. The patients with CRGNB had higher mortality than the patients without CRGNB.
CONCLUSION
The prevalence of MDROs in inter-hospital transferred critically ill patients was very high. Patients with MDROs in this study had longer hospital stay and higher mortality. These patients require more attention for isolation and hygiene protocols, and antibiotic choices.

Keyword

Intensive care unit; Multidrug-resistant organism; Infection

MeSH Terms

beta-Lactamases
Communicable Diseases
Critical Care
Critical Illness*
Delivery of Health Care
Gram-Negative Bacteria
Humans
Hygiene
Intensive Care Units
Length of Stay
Male
Methicillin-Resistant Staphylococcus aureus
Mortality
Prevalence*
Retrospective Studies
Vancomycin-Resistant Enterococci
beta-Lactamases