Factors Associated with Multidrug-Resistant Infection among Critically Ill Patients in an Urban Hospital: Retrospective Case-Control Study
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Abstract
This research was a retrospective case-control study to identify risk factors for drug-resistant infections in critically ill patients at a university hospital. The sample consisted of 114 patients, divided into the case and control groups, with 57 in each. Data collection utilized research record forms, with a content validity of .86 and reliability of .99. Data analysis was using descriptive statistics and multiple logistic regression.
The results showed that Carbapenem-resistant Acinetobacter baumannii with multidrug resistance (CRAB_MDR) was the most common pathogen found, with a rate of 50.88%. Significant risk factors included a history of hospital admission in the previous 3 months (OR adjust = 2.21; 95%CI: 1.00 - 4.87), sepsis (OR adjust = 2.56; 95%CI: 1.20 - 5.48), the use of ventilators (OR adjust = 2.46; 95%CI: 1.06 - 5.73), undergoing central venous catheter during intensive care unit (ICU) admission (OR adjust = 9.44; 95%CI: 1.23 - 72.42), and hospital stays longer than 60 days (OR adjust = 5.28; 95%CI: 1.14 - 24.53). Thus, in patients with sepsis care, nurses should apply the APACHE II score and other organ failure assessment tools to evaluate the severity of illness in patients with sepsis upon admission and periodically during antimicrobial therapy, particularly following new procedures in the ICU for monitoring the risk of drug-resistant infections.
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