Title : Impact of bacterial resistance in the ICU
Abstract:
Bacterial resistance is a major public health issue globally and is linked to an escalaJng burden of morbidity, mortality, and healthcare costs. This paper aimed to assess the clinical and economic consequences, including morbidity and mortality due to MDR infecJon in an intensive care unit (ICU). A retrospecJve, descripJve, and analyJcal study of 181 paJents diagnosed with MDR infecJon, comprising a total of 500 ICU admissions between 2017 and 2018. An analyJc analysis of all clinical, microbiological, treatment, and outcome data was available. The most prevalent isolated pathogens were Acinetobacter baumannii and Klebsiella pneumoniae, both with high resistance profiles. Factors associated with MDR are closely related to established risks such as diabetes mellitus, previous administraJon of anJbioJcs, increased SAPS II, invasive procedures, and use of vasopressor agents. One of the key findings of the study was that MDR infecJons significantly worsened outcomes, with a doubling of duraJon of stay on average in the hospital (16.2 vs. 7.4 days) and a significantly higher mortality rate (64% vs. 45.7%) compared with non-MDR cases. The independent funcJon of MDR as a severity factor in the ICU further complicates management and outcome for the paJents. This shows the key aspect of MDR pathogens that could be controlled as a proacJve approach in the se\ng of strict anJbioJc stewardship, effecJve infecJon prevenJon protocols, and early idenJficaJon of high-risk paJents. Therefore, the emergence of resistance from bacteria is sJll, despite great improvements in isolaJon, one of the main drivers of bad clinical outcomes, thus requiring a mulJ-pronged proacJve approach across disciplines in the ICU with the urgency required at the acute stage, in intensive care, for the control of bacterial colonizaJon and be_er paJent management.
