Ventilator-associated lower respiratory tract infections and bacteremia in medical and surgical critical care patients colonized by multidrug-resistant bacteria.
Multidrug-resistant bacteria colonization strongly linked to subsequent bloodstream infection with matching bacteria
Ventilator-associated lower respiratory tract infections and bacteremia in medical and surgical critical care patients colonized by multidrug-resistant bacteria.
We investigated the risk of bloodstream infections (bloodstream infections) and ventilator-associated lower respiratory tract (lower respiratory tract) infections, including pneumonia (VAP) and tracheobronchitis (VAT), due to multidrug-resistant bacteria (multidrug-resistant bacteria) in colonized critical care patients attended in the medical intensive care unit (medical intensive care unit) and surgical critical care unit (surgical critical care unit).
Observational, unicentric study including 573 consecutive adult patients (median age of 66 years; range, 18–85 years) and comprising a total of 585 admissions.
colonized patients had far higher risk of matching bloodstream infection
Colonization by multidrug-resistant bacteria was documented in 201 out of 585 admissions (34.4%), in which 261 multidrug-resistant bacteria were isolated, most frequently extended-spectrum beta-lactamase (extended-spectrum beta-lactamase)-producing Enterobacterales (n = 102) followed by MDR-S. maltophilia (n = 45), carbapenemase-producing Enterobacterales (n = 40), MDR-Gram-positive bacteria (n = 35), and MDR-P. aeruginosa (n = 28).
There were 21 multidrug-resistant bacteria bloodstream infections, mostly caused by Gram-negative bacteria (95.8%).
Multidrug-resistant bacteria colonization is a significant risk factor for the occurrence of MRDB-matched invasive infections in a mixed cohort of medical intensive care unit and surgical critical care unit patients.
multidrug-resistant bacteria screening cultures using a multi-site sampling approach may be useful for tailoring empirical antimicrobial treatments on an individual basis.