Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022
Abstract Introduction Antimicrobial resistance is a global issue, with the World Health Organization identifying it as one of the greatest threats to public health, with an estimated 4.95 million deaths linked to bacterial AMR in 2019. Our study aimed to determine the prevalence of mortality among m...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-10338-8 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595002647117824 |
|---|---|
| author | Sharifa Ezat WP M Norhidayah Muhammad Nur Amir AR |
| author_facet | Sharifa Ezat WP M Norhidayah Muhammad Nur Amir AR |
| author_sort | Sharifa Ezat WP |
| collection | DOAJ |
| description | Abstract Introduction Antimicrobial resistance is a global issue, with the World Health Organization identifying it as one of the greatest threats to public health, with an estimated 4.95 million deaths linked to bacterial AMR in 2019. Our study aimed to determine the prevalence of mortality among multidrug-resistant organism (MDRO)-infected patients in state hospitals and major specialist hospitals and to identify risk factors that could be associated with mortality outcomes. Methods This is a cross-sectional study performed at 28 hospitals under the Ministry of Health, Malaysia, involved in the National Surveillance of Multidrug-Resistant Organism, which surveys 6 MDROs (Acinetobacter baumanii, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant Entrobacterales (CRE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)). Results In terms of mortality, 9.6% (n = 951) of the patients died overall, whereas 90.4% (n = 8931) of the patients survived. Healthcare-acquired infection (HCAI) poses a high risk of mortality, with an adjusted odds ratio (aOR) of 2.91 (95% CI: 2.15–3.94). The presence of sterile specimens was significantly associated with increased mortality risk (aOR: 2.33, 95% CI: 2.02–2.68). Gram-negative bacteria had a greater mortality risk (aOR 1.63 95% CI: 1.37–1.93), whereas Acinetobacter baumanii had the highest prevalence of 30.7% (3033) among the 6 MDRO organisms isolated. Patients in medical-based departments had a greater mortality risk (aOR: 1.47, 95% CI: 1.22–1.75). Conclusion HCAIs, Gram-negative bacteria, sterile specimens, medical-based departments and state hospitals have been shown to be associated with increased mortality risk in patients with MDRO infections. Improved surveillance and reporting mechanisms are necessary to better understand the burden of MDRO infections and guide research funding allocation. |
| format | Article |
| id | doaj-art-cbdcad1fff0a46cbbe8df2ea62410b85 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-cbdcad1fff0a46cbbe8df2ea62410b852025-01-19T12:11:51ZengBMCBMC Infectious Diseases1471-23342025-01-0125111210.1186/s12879-024-10338-8Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022Sharifa Ezat WP0M Norhidayah1Muhammad Nur Amir AR2Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Federal Territory of Kuala LumpurDepartment of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Federal Territory of Kuala LumpurDepartment of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Federal Territory of Kuala LumpurAbstract Introduction Antimicrobial resistance is a global issue, with the World Health Organization identifying it as one of the greatest threats to public health, with an estimated 4.95 million deaths linked to bacterial AMR in 2019. Our study aimed to determine the prevalence of mortality among multidrug-resistant organism (MDRO)-infected patients in state hospitals and major specialist hospitals and to identify risk factors that could be associated with mortality outcomes. Methods This is a cross-sectional study performed at 28 hospitals under the Ministry of Health, Malaysia, involved in the National Surveillance of Multidrug-Resistant Organism, which surveys 6 MDROs (Acinetobacter baumanii, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant Entrobacterales (CRE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)). Results In terms of mortality, 9.6% (n = 951) of the patients died overall, whereas 90.4% (n = 8931) of the patients survived. Healthcare-acquired infection (HCAI) poses a high risk of mortality, with an adjusted odds ratio (aOR) of 2.91 (95% CI: 2.15–3.94). The presence of sterile specimens was significantly associated with increased mortality risk (aOR: 2.33, 95% CI: 2.02–2.68). Gram-negative bacteria had a greater mortality risk (aOR 1.63 95% CI: 1.37–1.93), whereas Acinetobacter baumanii had the highest prevalence of 30.7% (3033) among the 6 MDRO organisms isolated. Patients in medical-based departments had a greater mortality risk (aOR: 1.47, 95% CI: 1.22–1.75). Conclusion HCAIs, Gram-negative bacteria, sterile specimens, medical-based departments and state hospitals have been shown to be associated with increased mortality risk in patients with MDRO infections. Improved surveillance and reporting mechanisms are necessary to better understand the burden of MDRO infections and guide research funding allocation.https://doi.org/10.1186/s12879-024-10338-8Healthcare-acquired infectionsAntimicrobial resistanceBacteraemiaHospital mortality |
| spellingShingle | Sharifa Ezat WP M Norhidayah Muhammad Nur Amir AR Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 BMC Infectious Diseases Healthcare-acquired infections Antimicrobial resistance Bacteraemia Hospital mortality |
| title | Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 |
| title_full | Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 |
| title_fullStr | Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 |
| title_full_unstemmed | Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 |
| title_short | Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022 |
| title_sort | factors associated with multidrug resistant organism mdro mortality an analysis from the national surveillance of multidrug resistant organism 2018 2022 |
| topic | Healthcare-acquired infections Antimicrobial resistance Bacteraemia Hospital mortality |
| url | https://doi.org/10.1186/s12879-024-10338-8 |
| work_keys_str_mv | AT sharifaezatwp factorsassociatedwithmultidrugresistantorganismmdromortalityananalysisfromthenationalsurveillanceofmultidrugresistantorganism20182022 AT mnorhidayah factorsassociatedwithmultidrugresistantorganismmdromortalityananalysisfromthenationalsurveillanceofmultidrugresistantorganism20182022 AT muhammadnuramirar factorsassociatedwithmultidrugresistantorganismmdromortalityananalysisfromthenationalsurveillanceofmultidrugresistantorganism20182022 |