[Identification of risk factors of multiresistant infections on two intensive care units].

INTRODUCTION: Intensive care units are favourable environment for infections, many of them are caused by antibiotic resistant bacteria.

AIM: Identifying risk factors of ICU-acquired multiresistant infections.

METHOD: We performed observational study on two academic intensive care units (a multidisciplinary and a surgical ICU) between 01/09/2014 and 30/11/2015. Patients with a first infection caused by predefined organisms (P. aeruginosa, E. coli, K. pneumoniae, A. baumanni, S. aureus, S. epidermidis, E. faecium, E. faecalis or their multiresistant homologues) verified ≥48 h following admission were divided into two groups according to multiresistant (MRB) and non-multiresistant (n-MRB) bacteria. Prevalence of diabetes, COPD, smoking, alcoholism, acute surgery, malignancy were recorded. Their role was evaluated on pooled populations. Illness severity was marked by SAPS-II at admission and SOFA-score on day of positive culture. We also noted the length of stay, mechanical ventilation, antibiotic treatment.

RESULTS: Multidisciplinary ICU had 627, the surgical 1096 admissions. On the formal unit MRB group had 41 (48.1%), the n-MRB had 38 (51.9%) patients. On the latter unit 31 (54.4%) and 26 (45.6%) patients were involved. Smoking favoured multiresistant bacteria (RR 1.44 CI95% 1.04-2.0; p = 0.048). In case of malignancies n-MRB were more prominent (RR of MRB 0.68 CI95% 0.47-0.97; p = 0.026), other comorbidities had no significant impact. Illness severity scores did not differ at any of the ICUs. Preceding length of stay, days on mechanical ventilation or on antibiotics were similar in each group on both ICUs.

CONCLUSION: Smoking was revealed as a risk factor for MRB on our ICUs. We were not able to identify time-dependent risk factors. Orv Hetil. 2017; 158(32): 1259-1268.