Risk factors for multidrug-resistant Gram-negative bacteria infection in intensive care units: A meta-analysis

Abstract

Aims: To identify the risk factors for multidrug-resistant Gram-negative bacteria systematically and provide suggestions and an evidence-base for clinical measures.

Background: With the increase in the social population, changes in human behaviour and ecosystems, as well as economic development, bacteria have gradually produced drug resistance genes. These have swept through intensive care units causing high mortality.

Methods: Relevant literature which included case-control and cohort studies published from January 1999 to March 2017 were searched in the Cochrane Library, PubMed, Web of Science, and Medline. Meta-analysis was performed by using StataSE version 12.0 software.

Results: Eighteen studies of 235 publications were eligible. Male gender (OR 1.40, 95%CI 1.09, 1.80), having an operative procedure (OR 1.31, 95%CI 1.10, 1.56), a central venous catheter (OR 1.22, 95%CI 1.01, 1.48), mechanical ventilation (OR 1.25, 95%CI 1.07, 1.46), previous antibiotic therapy (OR 1.66, 95%CI 1.41, 1.96), length of ICU stay (weighted mean difference 8.18, 95%CI 0.27, 16.10), and types of health-associated infections were the identified risk factors for multidrug-resistant Gram-negative bacterial infection in intensive care units; moreover, diabetes mellitus was not.

Conclusion: Six risk factors were associated with multidrug-resistant Gram-negative bacterial infection in intensive care units. Antimicrobial stewardship, infection control, and medical staff prevention care are needed.

Keywords: intensive care units; meta-analysis; multidrug-resistant Gram-negative bacteria; risk factors.