Incidence of Drug-Resistant Hospital-Associated Gram-Negative Bacterial Infections, the Accompanying Risk Factors, and Clinical Outcomes with Treatment.
Lorina Ineta Badger-EmekaAbdullatif S Al RashedReem Y AljindanPromise Madu EmekaSayed A QuadriHayfa Habes AlmutairiPublished in: Antibiotics (Basel, Switzerland) (2023)
Extensive drug resistance to bacterial infections in hospitalised patients is accompanied by high morbidity and mortality rates due to limited treatment options. This study investigated the clinical outcomes of single and combined antibiotic therapies in extensive (XDR), multidrug-resistant (MDR) and susceptible strains (SS) of hospital-acquired infections (HAIs). Cases of hospital-associated drug-resistant infections (HADRIs) and a few susceptible strains from hospital wards were selected for this study. Bacteria identifications (IDs) and antimicrobial susceptibility tests (ASTs) were performed with a Vitek 2 Compact Automated System. Patients' treatment types and clinical outcomes were classified as alive improved (AI), alive not improved (ANI), or died. The length of hospital stay (LOHS) was acquired from hospital records. The HAI pathogens were Acinetobacter baumannii (28%), Escherichia coli (26%), Klebsiella pneumoniae (22%), Klebsiella (2%) species, Pseudomonas aeruginosa (12%), Proteus mirabilis (4%), and other Enterobacteriaceae . They were MDR (40.59%), XDR (24.75%), carbapenem-resistant Enterobacteriaceae (CRE, 21.78%) and susceptible (12%) strains. The treatments were either monotherapy or combined therapy with different outcomes. Monotherapy produced positive significant outcomes with E. coli infections, while for P. aeruginosa, there were no differences between the number of infections treated with either mono/combined therapies (50% each). Nonetheless, combined therapy had significant effects ( p < 0.05) as a treatment for A. baumannii and K. pneumoniae infections. Clinical outcomes and LOHS varied with infecting bacteria. The prevalence of XDR and MDR HAIs was found to be significantly high, with no association with treatment type, LOHS, or outcome.
Keyphrases
- multidrug resistant
- drug resistant
- acinetobacter baumannii
- gram negative
- klebsiella pneumoniae
- escherichia coli
- risk factors
- healthcare
- pseudomonas aeruginosa
- end stage renal disease
- newly diagnosed
- combination therapy
- ejection fraction
- adverse drug
- type diabetes
- stem cells
- metabolic syndrome
- acute care
- chronic kidney disease
- prognostic factors
- clinical trial
- emergency department
- peritoneal dialysis
- insulin resistance
- skeletal muscle
- machine learning
- open label
- high throughput
- study protocol