This article is more than 5 years old. Information may no longer be current.
Most patients hospitalized with MDROs readmitted within 1 year
Click Here to Manage Email Alerts
More than 60% of patients hospitalized with an infection caused by a multidrug-resistant organism were readmitted at least once within 1 year, according to recent findings published in Infection Control & Hospital Epidemiology.
Jason P. Burnham, MD, instructor of infectious disease in the department of internal medicine at Washington University School of Medicine, and colleagues found that almost a quarter of patients readmitted to the hospital were infected with another multidrug-resistant organism (MDRO).
The researchers examined the incidence of and potential risk factors for hospital readmissions among patients with previous MDRO infections during a retrospective cohort study at Barnes-Jewish Hospital from Jan. 1, 2006, to Oct. 1, 2015. Their analysis included 4,429 patients with MDROs that were isolated from the bloodstream, bronchoalveolar lavage/bronchial wash cultures or other sterile sites.
Overall, 22% of patients with MDROs died during the initial hospital visit or were discharged to hospice. Mortality was highest among patients with drug-resistant Acinetobacter (41.1%), whose risk for death was more than twice as high as patients with drug-resistant Staphylococcus aureus (RR = 2.45; P < .0001).
Among patients who survived the index hospitalization, 32.5% were readmitted at least once within 30 days, and 61.6% were readmitted within 1 year, accounting for 5,849 readmissions. More than 24% of patients readmitted to the hospital had another MDRO. The median time to a second positive MDRO culture after index hospitalization was 61.9 days.
The researchers found that having a bone marrow transplant (HR = 1.79), end-stage renal disease (HR = 1.43), lymphoma (HR = 1.49), MRSA (HR = 1.29) or carbapenem-resistant Pseudomonas aeruginosa (HR = 1.98) during the index hospitalization significantly increased the risk for having another MDRO during readmission.
A surprising finding was that patients readmitted with another MDRO were infected with a different pathogen class about one-third of the time, Burnham told Infectious Disease News. An exception to this was drug-resistant Acinetobacter, which was isolated only 9.1% of the time among readmitted patients who had this MDRO during index hospitalization.
“After an MDRO infection, patients are readmitted at high rates and frequently with another MDRO infection,” Burnham said. “Therefore, it is important to take into consideration previous microbiology results when choosing empiric antimicrobial therapy.” – by Stephanie Viguers
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts