Comparing Multidrug-Resistant (MDR) and non-MDR Patients in Intensive Care Unit: Outcomes and Challenges

Abstract

Background and Objectives: Antibiotic resistance is a major global health issue, particularly in intensive care units (ICUs), where critically ill patients are more vulnerable to multidrug-resistant (MDR) infections. The objective was to identify key factors contributing to the emergence of MDR pathogens in ICU patients.

Methodology: This prospective cross-sectional observational study was conducted at the medical ICU of Khan Research Laboratories (KRL) Hospital in Islamabad, Pakistan, from September 2022 to August 2023. A total of 750 adult patients (aged ≥18 years) were included in the study, divided into two groups: 375 patients with MDR infections (Study group) and 375 patients without MDR infections (Control group). Clinical and laboratory data were collected, including patient history, comorbidities, recent hospitalizations, and results from culture and antibiotic susceptibility testing and analysed using multivariate regression analysis.

Results: From a total of 750 patients, 375 were in each group, mean age was 59.5 ±15.9, with 405(53%) males. Patients with comorbidities, low Hb, renal or coagulation impairment were more in the MDR group. Age, previous history of cardiovascular disease, cerebrovascular disease mechanical ventilation, high CRP and number of indwelling lines and coagulation dysfunction were significant risk factors linked to mortality.

Conclusion: Modifiable factors like indwelling lines and use of mechanical ventilation play a critical role in the development of MDR infections in ICUs. Addressing these factors through targeted interventions may help reduce the burden of MDR pathogens and improve patient outcomes in critical care settings.