Title : Impact of bacterial resistance in the ICU
Abstract:
Bacterial resistance is a major public health issue globally and is linked to an escalating burden of morbidity, mortality, and healthcare costs. This paper aimed to assess the clinical and economic consequences, including morbidity and mortality due to MDR infection in an intensive care unit (ICU). A retrospective, descriptive, and analytical study of 181 patients diagnosed with MDR infection, comprising a total of 500 ICU admissions between 2017 and 2018. An analytic 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 administration of antibiotics, increased SAPS II, invasive procedures, and use of vasopressor agents. One of the key findings of the study was that MDR infections significantly worsened outcomes, with a doubling of duration 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 function of MDR as a severity factor in the ICU further complicates management and outcome for the patients. This shows the key aspect of MDR pathogens that could be controlled as a proactive approach in the setting of strict antibiotic stewardship, effective infection prevention protocols, and early identification of high-risk patients. Therefore, the emergence of resistance from bacteria is still, despite great improvements in isolation, one of the main drivers of bad clinical outcomes, thus requiring a multi-pronged proactive approach across disciplines in the ICU with the urgency required at the acute stage, in intensive care, for the control of bacterial colonization and better patient management.
