Association Between Malnutrition and Multi-Drug Resistant Bacterial Infections in Neurosurgical Intensive Care Unit Patients

Abstract

Aim: Patients in the neurosurgical intensive critical unit (ICU) face high rates of malnutrition and multidrug-resistant (MDR) infections. This study aimed to investigated the correlation between malnutrition and MDR bacterial infections, aiming to offer novel strategies for preventing and controlling MDR infections from the perspective of nutritional management in clinical practice. Methods: This retrospective cohort study analyzed 134 patients with MDR infections and 148 patients with non-MDR infections from November 2023 and May 2024 in neurosurgical ICU. MDR was defined as resistance to at least three antibiotic classes. Univariate, multivariate and correlation analyses were performed to explore the relationship between malnutrition and MDR infections. Results: The incidence of malnutrition risk in the MDR group was significantly higher than in the non-MDR group (P < 0.05). After adjusting for confounding factors, malnutrition was still independently associated with an increased risk of MDR infections (OR = 2.336; 95% CI = 1.361~4.112, P = 0.002). Furthermore, C-reactive protein level was negatively correlated with TP (r = −0.281, P < 0.001), ALB (r = −0.267, P < 0.001), PLB (r = −0.279, P < 0.001), Hb (r = −0.167, P < 0.01) and PNI (r = −0.257, P < 0.001), suggesting that higher infection severity was associated with poorer nutritional status. For bacterial strains, Acinetobacter baumannii accounted for the largest proportion in our study. Conclusion: Malnutrition is an independent risk factor for MDR infection in neurosurgical ICU patients. This finding highlights the need for integrated interventions targeting malnutrition in MDR prevention for neurosurgical ICU patients.