Incidence density rate of multidrug-resistant organism (MDRO) at a tertiary care teaching hospital: A retrospective cross-sectional study

Abstract

Background: Multidrug-resistant organisms (MDROs) has become a major public health concern. Rise of MDROs and their negative consequences on patient’s survival and health care costs need the assessment of their burden and implementation of practices to control their emergence and spread. There is a lack of literature mentioning incidence density rates (IDR) of various MDRO infections in Indian hospitals. Therefore, the study was conducted to determine the infection IDR and trend of various MDROs at a tertiary care teaching hospital. It will serve as a benchmark data for similar facilities using the same surveillance definitions and methodology. Materials and Methods: A retrospective cross-sectional study was conducted using culture data of ten years (January 2014 to December 2023) at Shree Krishna Hospital, Karamsad. MDRO studied included Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Carbapenem-resistant Enterobacterales (CRE), Multidrug-resistant (MDR) Acinetobacter spp. and MDR Pseudomonas aeruginosa. Results: A total of 7311 MDRO were detected from 1321793 in-patients, showing the overall IDR of 5.53 per 1000 patients-days. CRE (n = 3056, 42%) was the most common MDRO. The overall IDR per 1000 patient-days of MRSA, VRE, CRE, MDR-Acinetobacter spp., and MDR-P. aeruginosa was 0.81, 0.23, 2.31, 1.29 and 0.89 respectively. Overall MDRO IDR has increased from 4.20 to 8.77 from 2014 to 2023. An increasing IDR was observed for MRSA (0.57 to 1.48) and MDR-P. aeruginosa (0.43 to 1.60). Around 80% of the Acinetobacter spp. were MDR as compared to other MDRO. Conclusions: MDROs have been identified as a significant problem at our institute showing an increasing trend. We recommend following stringent infection control practices including isolation protocols as well as adherence to hospital antibiotic policy to reduce the burden of MDROs.