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. 2023 Sep 8;102(36):e35023.
doi: 10.1097/MD.0000000000035023.

Distribution of bacteria and risk factors in patients with multidrug-resistant pneumonia in a single center rehabilitation ward

Bangqi Wu  1   2 , Maohan Peng  2   3 , Yuanyuan Tong  1   2 , Xuhui Wang  1   2 , Yi Ding  1   2 , Xinyue Cheng  1   2
Affiliations

Distribution of bacteria and risk factors in patients with multidrug-resistant pneumonia in a single center rehabilitation ward

Bangqi Wu et al. Medicine (Baltimore). .

Abstract

Stroke patients may have dysphagia and frequent aspiration increasing exposure to antibiotics and the chance of multidrug-resistant (MDR) bacteria infection. This study investigated clinical risk factors and related antibiotic use of MDR bacteria infection in stroke patients in the rehabilitation ward, hoping that it can help prevent and reduce the condition of MDR bacteria. A retrospective cohort study was conducted using the database of stroke patients with pneumonia admitted to the rehabilitation ward from January 1, 2020, to June 30, 2022. The selected stroke patients were divided into the MDR and non-MDR groups. Analyze the infection bacteria of the 2 groups. Forward logistic regression was applied to identify possible independent MDR bacteria infection risk factors. A total of 323 patients were included. The top 3 common MDR pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. Almost all Pseudomonas aeruginosa and Acinetobacter baumannii are resistant to ertapenem. National Institute of Health stroke scale at admission was associated with MDR bacteria infection pneumonia (OR [odds ratio] = 1.078, 95%CI [1.017, 1.142]). Long-term tracheotomy (OR = 2.695, 95%CI [1.232, 5.897]), hypoalbuminemia (OR = 473, 95%CI [1.318, 4.642]), and bilateral cerebral hemisphere stroke (OR = 4.021, 95%CI [2.009, 8.048]) were significant clinical risk factors of MDR pneumonia after stroke. The detection rate of MDR bacteria has increased. Understanding the distribution and drug resistance of MDR bacteria in stroke patients with pneumonia in the neurological rehabilitation ward and the related susceptibility of MDR bacteria infection is necessary. This way, the treatment plan can be adjusted more timely, avoiding the abuse of antibiotics.

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Conflict of interest statement

This study analyzes count data has been approved by the Ethics Committee of the institution within which this study was undertaken. Moreover, it conforms to the provisions of the Declaration of Helsinki. This clinical study is a retrospective study, which only collects the clinical data of patients, does not interfere with the treatment plan of patients, and will not bring risks to the physiology of patients. Research data collection complies with national laws, regulations, and social ethics. The authors received the approval of the institutional review board: The patient consent to review the medical records in this research was not required because the study design of this research is a retrospective study. It only collects the patient clinical data, does not interfere with the patient treatment plan, will not bring risks to the patient physiology, has no harm to patients, and has no conflict of interest. The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow chart of the study. A total of 1302 stroke patients with pneumonia were discharged from the hospital from January 1, 2020 to June 30, 2022. Through inclusion and exclusion criteria, a total of 323 individuals were ultimately included, including 85 patients infected with multidrug-resistant bacteria.
See this image and copyright information in PMC

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