Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units

n recent years, the prevalence of hospital-acquired infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB) has surged globally, posing significant threats to patient safety and life. These infections, especially prevalent in intensive care units (ICUs), are associated with high mortality rates, ranging from 26% to 80%, and contribute to escalating healthcare costs. Common CRGNB include Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae.

Treatment challenges are significant due to the nephrotoxicity and uncertain efficacy of agents like colistin and tigecycline, alongside the limited development of new antibiotics. Key risk factors for CRGNB infections encompass antibiotic exposure, invasive procedures, and prolonged ICU stays. Additionally, asymptomatic colonization increases both the risk of infection and the potential for cross-transmission. Data from active surveillance in our hospital from 2017 to 2021 indicate rising carbapenem resistance rates in A. baumannii (96.5% to 100%), K. pneumoniae (49.2% to 79.6%), and P. aeruginosa (45.8% to 93.1%).

To mitigate these challenges, identifying high-risk patients and implementing early infection control measures are essential. This involves strict adherence to standard and contact precautions, active microbiological surveillance, feedback mechanisms, reducing the use and duration of invasive devices, thorough environmental cleaning, multidisciplinary collaboration, and the development of antimicrobial management protocols tailored to the ICU. Future studies are crucial to further elucidate these findings and better understand the carrier profile of these resilient microorganisms.

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