Factors associated with multidrug-resistant bacteria in healthcare-associated infections: a pediatric intensive care unit case-control study

Einstein (Sao Paulo). 2022 Apr 22:20:eAO6704. doi: 10.31744/einstein_journal/2022AO6704. eCollection 2022.

Abstract

Objective: To investigate the prevalence of factors related to healthcare-associated infections, caused by multidrug-resistant bacteria, in a pediatric intensive care unit.

Methods: A retrospective case-control study conducted from January 1, 2007 to December 31, 2018, in São Paulo (SP), Brazil. The study was carried out at the pediatric intensive care unit of a high-complexity, tertiary care general hospital. The study included patients aged 1 month to 19 years, admitted to the pediatric intensive care unit, diagnosed as healthcare-associated infections.

Results: There was significant evidence of infection by multidrug-resistant bacteria associated with immunosuppressed patients (p<0.001), in whom the likelihood of multidrug-resistant bacteria infection was estimated to be nine-fold higher than among non-immunosuppressed patients (OR 8.97; 95%CI 2.69-29.94). In the analysis of multiple logistic regression model, we observed that immunosuppressed patients had an 8.5-fold higher chance of multidrug-resistant bacteria infection when compared to non-immunosuppressed patients (OR 8.48; 95%CI 2.54-28.35; p=0.001). There is evidence of association between the Case Group and presence of Gram-positive (p=0.007), coagulase-negative Staphylococcus (p<0.001), and Gram-negative (p=0.041) microorganisms.

Conclusion: The immunocompromised-state variable is a factor related to healthcare-associated infections caused by multidrug-resistant bacteria, and the Case Group presented higher proportions of Gram-positive microorganisms and coagulase-negative Staphylococcus.

MeSH terms

  • Bacteria
  • Brazil / epidemiology
  • Case-Control Studies
  • Child
  • Coagulase
  • Cross Infection* / epidemiology
  • Cross Infection* / microbiology
  • Delivery of Health Care
  • Gram-Negative Bacterial Infections* / diagnosis
  • Gram-Negative Bacterial Infections* / epidemiology
  • Gram-Negative Bacterial Infections* / microbiology
  • Humans
  • Intensive Care Units, Pediatric
  • Retrospective Studies

Substances

  • Coagulase