Abstract

SALDARRIAGA QUINTERO, Eliana; ECHEVERRI-TORO, Lina  and  OSPINA OSPINA, Sigifredo. Clinical factors associated with bacterial multidrug resistance in a quaternary care hospital . Infect. [online]. 2015, vol.19, n.4, pp.161-167. ISSN 0123-9392.  https://doi.org/10.1016/j.infect.2015.04.003.

Introduction: Infections caused by multidrug-resistant bacteria increase morbidity, mortality, care costs and cause difficulties with treatment. Understanding the factors associated with infection by multidrug resistant bacteria is key to proper monitoring and control and to enabling improved patients care in hospitals. Objective: To determine the clinical factors associated with infection by multidrug-resistant bacteria in a quaternary care hospital. Materials and methods: A retrospective case-control study was performed using the medical records of hospitalized patients from October 2011 to July 2014. The selection of controls was carried out by simple random sampling. The data analysis was performed using SPSS 21.0 software, descriptive and association measures (Mann-Whitney, chi-squared and OR) were calculated, and a multivariate model was performed using logistic regression to calculate the adjusted OR. Results: We found significant associations with immunosuppressive drugs (OR = 2.58), transplantation (OR = 2,88), hospitalization (OR = 1.73) and surgery (OR = 1.78) in the 3 months prior to infection, dialysis (OR = 3.53), central venous catheters (OR = 2.16), parenteral nutrition (OR = 2.06) and antibiotic therapy within 48 h prior to infection (OR = 1.86). In the multivariate model previous hospitalization was important (OR = 1.83) and COPD (OR = 3.07). Conclusions: Previous hospitalization and COPD were independent risk factors for acquiring infections by multidrug resistant bacteria. In addition, although it was not possible to estimate risk because we did not find exposed controls, parenteral nutrition and the use of quinolones in the 48 h prior to infection were important factors in the occurrence of infection.

Keywords : Drug resistance; Nosocomial infection; Risk factors; Colombia.

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