Clinical Characteristics and Outcome of MDR/XDR Bacterial Infections in a Neuromuscular Semi-Intensive/Sub-Intensive Care Unit.
Arta KarruliAlessia MassaLorenzo BertolinoRoberto AndiniPasquale SansoneSalvatore DongiovanniMaria Caterina PaceVincenzo PotaEmanuele Durante-MangoniPublished in: Antibiotics (Basel, Switzerland) (2022)
(1) Background: The aim of this study was to assess the clinical and microbiological characteristics of multidrug-resistant infections in a neuromuscular semi-intensive/sub-intensive care unit; (2) Methods: Retrospective analysis on data from 18 patients with NMD with proven MDRO/XDRO colonisation/infection from August 2021 to March 2022 was carried out; (3) Results: Ten patients were males (55.6%), with a median age of 54 years, and there were fourteen patients (77.8%) with amyotrophic lateral sclerosis. All patients had at least one invasive device. Ten (55.6%) patients developed MDRO/XDRO infection (with a median time of 24 days) while six (33.3%) were colonised. The Charlson comorbidity index was >2 in both groups but higher in the infected compared with the colonised (4.5 vs. 3). Infected patients were mostly females (seven patients) with a median age of 62 years. The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa, infecting four (28.6%) patients each. Of eighteen infectious episodes, nine were pneumonia (hospital-acquired in seven cases). Colistin was the most commonly active antibiotic while carbapenems were largely inactive. Eradication of infection occurred in seven infectious episodes (38.9%). None of those with infection died; (4) Conclusions: MDRO/XDRO infections are common in patients with neuromuscular diseases, with carbapenem-resistant non-fermenting Gram-negative bacilli prevailing. These infections were numerically associated with the female sex, greater age, and comorbidities. Both eradication and infection-related mortality appeared low. We highlight the importance of infection prevention in this vulnerable population.
Keyphrases
- multidrug resistant
- gram negative
- end stage renal disease
- acinetobacter baumannii
- intensive care unit
- pseudomonas aeruginosa
- chronic kidney disease
- ejection fraction
- drug resistant
- newly diagnosed
- peritoneal dialysis
- healthcare
- emergency department
- type diabetes
- patient reported
- staphylococcus aureus
- risk factors
- coronary artery disease
- extracorporeal membrane oxygenation
- deep learning
- helicobacter pylori