Risk factors for infection with multidrug-resistant organisms in Haryana, India

Abstract

Objective To investigate risk factors for multi-drug resistant organism (MDRO) infection within a hospital population in northern India. Design This case-control study examined MDRO infection risk factors including diet, health history and medical device use. We administered a diet questionnaire to collect data on usual diet and collected data on other risk factors from chart review. Setting Patients were recruited from a tertiary care hospital in northern India Patients All participants were inpatients identified through hospital microbiology reports. A total of 39 MDRO-patient cases and 91 controls were included. Methods Descriptive statistics, univariate analysis, and multivariate logistic regression were performed to evaluate the association between risk factors and MDRO infection. Results All cases had gram-negative MDRO infections. Univariate analyses found length of hospital stay, connective tissue disease, hospitalization in the last 12 months, hospitalization of a family member, in-hospital antibiotic use, antibiotic use in the last 12 months, and feeding tube, central venous line, and urinary catheter use to be significantly different between cases and controls. Logistic regression showed a more than three-fold increase in the odds of infection with antibiotic use in the last twelve months (OR 3.30, 95% CI 1.22–8.91) and urinary catheter use (OR 3.63, 95% CI 1.14–11.58). Differences in dietary preferences and fruit, vegetable, and fiber consumption were not significantly associated with infection. Conclusions Antibiotic use is a major driver of MDRO infections. Our findings suggest that interventions optimizing antibiotic stewardship and reducing device use should be a priority to prevent MDRO infections.

Risk factors for acquisition of ESBL-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator-associated hospital-acquired pneumonia in a tertiary care hospital in Indonesia

“…We reported that the use of 3 rd generation cephalosporins for more than three days and length of stay of more than 10 days were the significant risk factors associated with the acquisition of ESBL-producing E. coli and K. pneumoniae among NV-HAP patients. The previous studies showed the association between prior antibiotics use and ESBL infections; however, the duration of the antibiotics use particularly 3 rd generation of cephalosporins among NV-HAP patients was not described clearly (Tham et al, 2013;Shaikh et al, 2015;Kalluru et al, 2018;Chen et al, 2020;Lin et al, 2021). Ceftriaxone, a 3 rd generation of cephalosporin, is the most common empirical antibiotic therapy used in Indonesian hospitals (Farida et al, 2017;Zavira et al, 2021).…”

Phylogenetic analysis of multidrug resistant E. coli isolates from the urinary tract in Bushenyi district, Uganda using the new Clermont phylotyping method

“…These nosocomial MDR organisms includes: methicillinresistant S. aureus (MRSA), vancomycin-resistant enterococci (VRE), and resistant Gram-negative bacteria. The resistant Gram-negative bacteria that cause UTIs arise from the human gut flora (Sarowska et al, 2019;Kalluru et al, 2018). Patients and staffs harboring these MDR organisms potentially contaminates high-touch surfaces in hospital wards or patients' admission rooms, hence increasing the risk of infecting other patients, hospital staffs and visitors that may come into contact with these contaminated surfaces (Dancer , 2014;Nseir et al, 2011).…”

Study on Multi Drug Resistant Opportunistic Pathogens Obtained from Clinical Settings of Tamil Nadu for Developing Novel Alternative Therapeutics

“…They emerge from the roots of normal commensal symbionts or microbes obtained from the environment. Acquiesce may be from a diseased person or hospital setting, which can be (11) and Klebsiella species (7). Similarly, Salmani et al 33 .…”

“…The main concern in these cases is the antibiotic resistance exhibited by these opportunistic pathogens. Because of constant exposure towards antibiotics and in close contact with pathogens, these opportunistic pathogens can develop resistance through gene transfer or by mutation 11,12 .…”