- Increasing rates of community-acquired (CA) multidrug-resistant (MDR) infections are linked to hospitalizations, longer length of stay (LOS), and clinical failure in elderly patients with comorbidities.
Why this matters
- This increase in CA-MDR infections warrants clinical vigilance and timely diagnosis.
- Familiarity with locally circulating MDR pathogens and effective treatment is recommended.
- Among 194 patients, 60.8% (59/97) MDR isolates were community-onset (CO) health-care-associated (HCA) infections.
- Most common CO-HCA infection risk factors:
- Chemotherapy, home intravenous therapy, or wound care: 7.2% (n=7).
- Vs non-MDR patients, MDR patients had higher rates of:
- Day 30 clinical failure : 16.5% vs 7.2% (P=.046),
- All-cause mortality: 35.1% vs 21.6% (P=.038).
- Multivariate, day-30 clinical failure was significantly associated (ORs) with:
- Age: 1.07 (P=.038),
- Sequential organ failure assessment score: 1.45 (P=.002).
- All-cause mortality with MDR was tied to (HRs):
- Age: 1.06 (P<.001>
- Higher Charlson score: 1.2 (P=.002).
- Hospital LOS: median, 11 (interquartile range [IQR], 7-16) days vs 7 (IQR, 5-11) days (P<.001 and>
- Stays in emergency department: median, 1 (IQR, 1-2) day vs 1 (IQR, 1-1.75) day (P<.001>
- Case-control analysis of clinical impact of CA-, CO-HCA MDR infections of any kind requiring hospitalization in Spanish adults, 2015-2016.
- Funding: None.
- Limited generalizability.
- Heterogeneity bias.
- Missing confounders.