Multi-Drug Resistant Organisms Infection Impact on Patients Length of Stay in Respiratory Care Ward.

Yi-Ping Chen,Jung-Ren Chen,Ko Chang,Xuan-Di Cao,Xian-Wen Tasi,Chien-Sen Liao

doi:10.3390/antibiotics10050608

Abstract

This study aimed to investigate the effects of multi-drug-resistant organism (MDRO) infection and other factors on the length of hospital stay (LOS) of patients in the respiratory care ward (RCW) of a regional hospital in Taiwan. In this retrospective study, we collected cases from MDRO-infected patients in the RCW from January 2016 to March 2020. The RCW comprises 13 beds in total. There were 106 infected patients, of which 42 were in the case group (infected with MDROs) and 64 were in the control group (not infected with MDROs). Clinical specimens were inoculated in a selective medium to isolate the pathogenic bacteria by standard procedures. The results showed the main factors affecting the LOS were: patients with MDRO infection, patients discharged from the RCW, and patients who underwent catheterization. The LOS of patients infected with MDROs was significantly longer than that of patients without MDRO infection (β = 0.55, 95% CI = 0.02–1.09), with the case group and the control group being 479.8 ± 546.5 and 307.3 ± 436.2 days, respectively. Infection with carbapenem-resistant Pseudomonas aeruginosa (CRPA) was associated with a longer LOS than other MDRO strains. These findings have important implications for infection control in RCW and in better tracking the health of patients.

Highlights

Airway protection in patients with respiratory distress requires intubation and ventilation support via an artificial airway
Taking a similar approach to one study comparing different multi-drug-resistant organism (MDRO) infections in mainland China [7], we found that the increase in length of hospital stay (LOS) associated with Healthcare-associated infections (HAIs) due to carbapenem-resistant Pseudomonas aeruginosa (CRPA) was significantly longer than other MDRO infections, other than VRE and CR-E. coli infection (p < 0.05)
We investigated the effects of MDRO infection and other factors on the LOS of patients in the respiratory care ward (RCW) of a regional hospital in Taiwan

Summary

Introduction

Airway protection in patients with respiratory distress requires intubation and ventilation support via an artificial airway. It is easy to damage the natural defense mechanisms of the oropharynx, causing bacterial infection of the lower respiratory tract, leading to ventilator-associated pneumonia (VAP) [1,2]. VAP is a serious complication that significantly impacts the prognosis of patients in RCWs, and it incurs additional medical expenses [3]. Repeated cases of VAP have been documented in critically ill patients having undergone endotracheal intubation and ventilation apparatus support in RCWs [4]. These patients require a variety of invasive interventions, and the long-term hospital stay has a huge impact on medical costs. Antibiotics that are widely used in order to avoid infections in patients drive the generation of multi-drug-resistant organisms (MDROs): pathogenic bacteria resistant to more than one kind of antibiotic, which lead to poor therapeutic control by antibiotics [5,6]

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