Sunday , January 24 2021

Hospital mortality is higher among patients with drug-resistant infections

In one of the largest studies to measure the burden of antibiotic resistance in low or middle income countries, researchers at the Center for Dynamics of Disease, Economics & Policy reported that hospital deaths were significantly higher among patients infected with multi-drugs. resistant (MDR) or pathogens that are resistant to many drugs (XDR) include Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii.

Researchers analyzed the results of antimicrobial susceptibility tests and mortality outcomes for more than 4,000 patients who visited one of ten tertiary or quaternary referral hospitals throughout India in 2015. Pathogens were classified as MDR or XDR based on drug susceptibility profiles proposed by the European Center for Disease Control and US. and Prevention. Death data is limited to hospital deaths. Additional demographic and clinical data including age, sex, place of acquisition of infection, and location in the hospital (i.e. intensive care unit) [ICU] or non-intensive care unit) also collected.

The overall death rate among all study participants was 13.1 percent, with death as high as 29.0 percent among infected patients A. baumannii. Patients who died were more likely to be older and be admitted to the ICU during the test. The researchers also found that among MDR infections, those caused by Gram-negative bacteria were associated with higher mortality rates compared to those caused by Gram-positive bacteria, with rates of 17.7 percent and 10.8 percent, respectively. .

The study showed that patients who received MDR bacterial infection were 1.57 times more likely to die, compared with patients with the same susceptible infection, while patients who received XDR infection were 2.65 times more likely to die when calculating age, sex, place of infection, and number of co-infections.

At ICU and non-ICU, the likelihood of mortality is higher among patients with XDR infection; this relationship is driven by Gram-negative infections (for example, XDR K. pneumoniae) which highlight the importance of identifying this infection quickly among all patients.

In India, Gram-negative MDR and XDR bacterial infections occur frequently, and effective availability of antibiotic therapy decreases. This study provides broader insights into the urgent need to improve surveillance, research, and antimicrobial stewardship efforts throughout the world. The researchers further noted that these findings on the burden of death on antibiotic resistance could help in the development of policy efforts to prioritize antibiotic resistance as a threat to global public health and to inform future efforts to measure and track the burden of resistance across the middle and lower classes. incoming countries.

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