Prevalence and predictors of multidrug resistant organism infections in critically ill patients with opioid use disorder: a multicenter retrospective cohort study.

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Zeeshan M Rizwan, Haris Akhtar, Julie L Cunningham, Kristin C Cole, John C O'Horo, Ognjen Gajic, Ryan W Stevens
{"title":"Prevalence and predictors of multidrug resistant organism infections in critically ill patients with opioid use disorder: a multicenter retrospective cohort study.","authors":"Zeeshan M Rizwan, Haris Akhtar, Julie L Cunningham, Kristin C Cole, John C O'Horo, Ognjen Gajic, Ryan W Stevens","doi":"10.1017/ice.2025.64","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Patients with Opioid Use Disorder (OUD) are prone to Multidrug-Resistant Organism (MDRO) colonization and infections, thus at risk for worse outcomes during critical illness. Understanding the prevalence and predictors of MDRO infections is essential to optimize interventions and treatments.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>The study evaluated the prevalence of MDRO isolation among adults with OUD admitted to an intensive care unit (ICU) between January 1, 2018, and July 31, 2023. It included adults admitted to an ICU with bacterial infections and positive cultures obtained within 48 hours of admission. Demographics, clinical traits, and MDRO isolation rates were analyzed using descriptive statistics, univariate methods, and Least Absolute Shrinkage and Selection Operator (LASSO) regression.</p><p><strong>Results: </strong>MDRO isolation occurred in 178 of 790 patients (22.5%), with methicillin-resistant <i>Staphylococcus aureus</i> as the most frequently isolated organism. LASSO regression identified housing insecurity (OR: 1.79, 95% CI 1.09-2.93, <i>P</i> = .022), no receipt of medications for OUD treatment (OR: 1.56, 95% CI 1.06-2.29, <i>P</i> = .023), positive hepatitis C virus (HCV) status (OR: 2.19, 95% CI 1.19-4.03, <i>P</i> = .012), and intravenous antibiotic use in the prior 90 days (OR: 1.04 per 24 h, 95% CI 1.01-1.07, <i>P</i> = .007) as significant predictors of MDRO isolation.</p><p><strong>Conclusions: </strong>The study highlights a high prevalence of MDRO isolation in critically ill OUD patients admitted for infection-related issues with positive cultures obtained within 48 hours of admission, influenced by factors like housing insecurity, no receipt of medications for OUD treatment, HCV status, and prior antibiotic use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control and Hospital Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/ice.2025.64","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Patients with Opioid Use Disorder (OUD) are prone to Multidrug-Resistant Organism (MDRO) colonization and infections, thus at risk for worse outcomes during critical illness. Understanding the prevalence and predictors of MDRO infections is essential to optimize interventions and treatments.

Design: Retrospective cohort study.

Methods: The study evaluated the prevalence of MDRO isolation among adults with OUD admitted to an intensive care unit (ICU) between January 1, 2018, and July 31, 2023. It included adults admitted to an ICU with bacterial infections and positive cultures obtained within 48 hours of admission. Demographics, clinical traits, and MDRO isolation rates were analyzed using descriptive statistics, univariate methods, and Least Absolute Shrinkage and Selection Operator (LASSO) regression.

Results: MDRO isolation occurred in 178 of 790 patients (22.5%), with methicillin-resistant Staphylococcus aureus as the most frequently isolated organism. LASSO regression identified housing insecurity (OR: 1.79, 95% CI 1.09-2.93, P = .022), no receipt of medications for OUD treatment (OR: 1.56, 95% CI 1.06-2.29, P = .023), positive hepatitis C virus (HCV) status (OR: 2.19, 95% CI 1.19-4.03, P = .012), and intravenous antibiotic use in the prior 90 days (OR: 1.04 per 24 h, 95% CI 1.01-1.07, P = .007) as significant predictors of MDRO isolation.

Conclusions: The study highlights a high prevalence of MDRO isolation in critically ill OUD patients admitted for infection-related issues with positive cultures obtained within 48 hours of admission, influenced by factors like housing insecurity, no receipt of medications for OUD treatment, HCV status, and prior antibiotic use.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信