Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study
Introduction The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictiv...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2022-02, Vol.48 (1), p.659-665 |
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| container_title | European journal of trauma and emergency surgery (Munich : 2007) |
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| creator | Nohl, André Hamsen, Uwe Jensen, Kai Oliver Sprengel, Kai Ziegenhain, Franziska Lefering, Rolf Dudda, Marcel Schildhauer, Thomas Armin Wegner, Alexander |
| description | Introduction
The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome.
Methods
Retrospective study of four level-1 trauma centers including all patients after major trauma with an injury severity score (ISS) ≥ 9 admitted to an intensive care unit (ICU) between 2013 and 2017. Outcome was measured using the Glasgow outcome scale (GOS).
Results
Of 4131 included patients, 95 (2.3%) had a positive screening for MDRO. Risk factors for MDRO were male gender (OR 1.73 [95% CI 1.04–2.89]), ISS (OR 1.01 [95% CI 1.00–1.03]), PRBC’s given (OR 1.73 [95% CI 1.09–2.78]), ICU stay > 48 h (OR 4.01 [95% CI 2.06–7.81]) and mechanical ventilation (OR 1.85 [95% CI 1.01–3.38]). A positive MDRO infection correlates with worse outcome. MDRO positive cases GOS: good recovery = 0.6%, moderate disability = 2.1%, severe disability = 5.6%, vegetative state = 5.7% (
p
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| doi_str_mv | 10.1007/s00068-020-01545-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2463607123</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2463607123</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-adfd70ea4090af28799888c83cb69f0964beaa50ac1973c5318bb400e873d0f93</originalsourceid><addsrcrecordid>eNp9kctu1DAUhiMEohd4ARbIEpsikXJ8SWKzq4YClVpV4rK2Thxn6mFiB9tR1ZfoM-MypUgsuvKxzvf_tvRV1SsKxxSge58AoJU1MKiBNqKpxZNqn8qW10oJ-vRh5nyvOkhpU2hoG_a82uOcMapkt1_dnnnjBuuNfUfcNKPJBP1Aoks_yVhuISYyhkimZZvdEJd1HW1yKaPPJMQ1epemRI4uPn69fEucJzNmZ31O5NrlKzLhpmRzxGXCDwTJ6RLDbNGTi7s6U0AbySpchZjJt7wMNy-qZyNuk315fx5WPz6dfl99qc8vP5-tTs5rw7sm1ziMQwcWBSjAkclOKSmlkdz0rRpBtaK3iA2goarjpuFU9r0AsLLjA4yKH1ZHu945hl-LTVlPLhm73aK3YUmaiZa30FHGC_rmP3QTlujL7zRrWVtAoZpCsR1lYkgp2lHP0U0YbzQFfWdL72zpYkv_saVFCb2-r176yQ4Pkb96CsB3QCorv7bx39uP1P4GPIOgzA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2626463495</pqid></control><display><type>article</type><title>Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Nohl, André ; Hamsen, Uwe ; Jensen, Kai Oliver ; Sprengel, Kai ; Ziegenhain, Franziska ; Lefering, Rolf ; Dudda, Marcel ; Schildhauer, Thomas Armin ; Wegner, Alexander</creator><creatorcontrib>Nohl, André ; Hamsen, Uwe ; Jensen, Kai Oliver ; Sprengel, Kai ; Ziegenhain, Franziska ; Lefering, Rolf ; Dudda, Marcel ; Schildhauer, Thomas Armin ; Wegner, Alexander</creatorcontrib><description>Introduction
The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome.
Methods
Retrospective study of four level-1 trauma centers including all patients after major trauma with an injury severity score (ISS) ≥ 9 admitted to an intensive care unit (ICU) between 2013 and 2017. Outcome was measured using the Glasgow outcome scale (GOS).
Results
Of 4131 included patients, 95 (2.3%) had a positive screening for MDRO. Risk factors for MDRO were male gender (OR 1.73 [95% CI 1.04–2.89]), ISS (OR 1.01 [95% CI 1.00–1.03]), PRBC’s given (OR 1.73 [95% CI 1.09–2.78]), ICU stay > 48 h (OR 4.01 [95% CI 2.06–7.81]) and mechanical ventilation (OR 1.85 [95% CI 1.01–3.38]). A positive MDRO infection correlates with worse outcome. MDRO positive cases GOS: good recovery = 0.6%, moderate disability = 2.1%, severe disability = 5.6%, vegetative state = 5.7% (
p
< 0.001).
Conclusions
MDRO in severely injured patients are rare but associated with a worse outcome at hospital discharge. We identified potential risk factors for MDRO in severely injured patients. Based on our results, we recommend a standardized screening procedure for major trauma patients.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-020-01545-4</identifier><identifier>PMID: 33221987</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antibiotics ; Cohort analysis ; Cohort Studies ; Critical Care Medicine ; Drug resistance ; Drug Resistance, Multiple, Bacterial ; Emergency medical care ; Emergency Medicine ; Humans ; Incidence ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Multidrug resistant organisms ; Original Article ; Retrospective Studies ; Risk Factors ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Trauma ; Trauma centers ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2022-02, Vol.48 (1), p.659-665</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>2020. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-adfd70ea4090af28799888c83cb69f0964beaa50ac1973c5318bb400e873d0f93</citedby><cites>FETCH-LOGICAL-c375t-adfd70ea4090af28799888c83cb69f0964beaa50ac1973c5318bb400e873d0f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-020-01545-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-020-01545-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33221987$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nohl, André</creatorcontrib><creatorcontrib>Hamsen, Uwe</creatorcontrib><creatorcontrib>Jensen, Kai Oliver</creatorcontrib><creatorcontrib>Sprengel, Kai</creatorcontrib><creatorcontrib>Ziegenhain, Franziska</creatorcontrib><creatorcontrib>Lefering, Rolf</creatorcontrib><creatorcontrib>Dudda, Marcel</creatorcontrib><creatorcontrib>Schildhauer, Thomas Armin</creatorcontrib><creatorcontrib>Wegner, Alexander</creatorcontrib><title>Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Introduction
The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome.
Methods
Retrospective study of four level-1 trauma centers including all patients after major trauma with an injury severity score (ISS) ≥ 9 admitted to an intensive care unit (ICU) between 2013 and 2017. Outcome was measured using the Glasgow outcome scale (GOS).
Results
Of 4131 included patients, 95 (2.3%) had a positive screening for MDRO. Risk factors for MDRO were male gender (OR 1.73 [95% CI 1.04–2.89]), ISS (OR 1.01 [95% CI 1.00–1.03]), PRBC’s given (OR 1.73 [95% CI 1.09–2.78]), ICU stay > 48 h (OR 4.01 [95% CI 2.06–7.81]) and mechanical ventilation (OR 1.85 [95% CI 1.01–3.38]). A positive MDRO infection correlates with worse outcome. MDRO positive cases GOS: good recovery = 0.6%, moderate disability = 2.1%, severe disability = 5.6%, vegetative state = 5.7% (
p
< 0.001).
Conclusions
MDRO in severely injured patients are rare but associated with a worse outcome at hospital discharge. We identified potential risk factors for MDRO in severely injured patients. Based on our results, we recommend a standardized screening procedure for major trauma patients.</description><subject>Antibiotics</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Critical Care Medicine</subject><subject>Drug resistance</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Emergency medical care</subject><subject>Emergency Medicine</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multidrug resistant organisms</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Trauma</subject><subject>Trauma centers</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kctu1DAUhiMEohd4ARbIEpsikXJ8SWKzq4YClVpV4rK2Thxn6mFiB9tR1ZfoM-MypUgsuvKxzvf_tvRV1SsKxxSge58AoJU1MKiBNqKpxZNqn8qW10oJ-vRh5nyvOkhpU2hoG_a82uOcMapkt1_dnnnjBuuNfUfcNKPJBP1Aoks_yVhuISYyhkimZZvdEJd1HW1yKaPPJMQ1epemRI4uPn69fEucJzNmZ31O5NrlKzLhpmRzxGXCDwTJ6RLDbNGTi7s6U0AbySpchZjJt7wMNy-qZyNuk315fx5WPz6dfl99qc8vP5-tTs5rw7sm1ziMQwcWBSjAkclOKSmlkdz0rRpBtaK3iA2goarjpuFU9r0AsLLjA4yKH1ZHu945hl-LTVlPLhm73aK3YUmaiZa30FHGC_rmP3QTlujL7zRrWVtAoZpCsR1lYkgp2lHP0U0YbzQFfWdL72zpYkv_saVFCb2-r176yQ4Pkb96CsB3QCorv7bx39uP1P4GPIOgzA</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Nohl, André</creator><creator>Hamsen, Uwe</creator><creator>Jensen, Kai Oliver</creator><creator>Sprengel, Kai</creator><creator>Ziegenhain, Franziska</creator><creator>Lefering, Rolf</creator><creator>Dudda, Marcel</creator><creator>Schildhauer, Thomas Armin</creator><creator>Wegner, Alexander</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20220201</creationdate><title>Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study</title><author>Nohl, André ; Hamsen, Uwe ; Jensen, Kai Oliver ; Sprengel, Kai ; Ziegenhain, Franziska ; Lefering, Rolf ; Dudda, Marcel ; Schildhauer, Thomas Armin ; Wegner, Alexander</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-adfd70ea4090af28799888c83cb69f0964beaa50ac1973c5318bb400e873d0f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibiotics</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Critical Care Medicine</topic><topic>Drug resistance</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>Emergency medical care</topic><topic>Emergency Medicine</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multidrug resistant organisms</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Trauma</topic><topic>Trauma centers</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nohl, André</creatorcontrib><creatorcontrib>Hamsen, Uwe</creatorcontrib><creatorcontrib>Jensen, Kai Oliver</creatorcontrib><creatorcontrib>Sprengel, Kai</creatorcontrib><creatorcontrib>Ziegenhain, Franziska</creatorcontrib><creatorcontrib>Lefering, Rolf</creatorcontrib><creatorcontrib>Dudda, Marcel</creatorcontrib><creatorcontrib>Schildhauer, Thomas Armin</creatorcontrib><creatorcontrib>Wegner, Alexander</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nohl, André</au><au>Hamsen, Uwe</au><au>Jensen, Kai Oliver</au><au>Sprengel, Kai</au><au>Ziegenhain, Franziska</au><au>Lefering, Rolf</au><au>Dudda, Marcel</au><au>Schildhauer, Thomas Armin</au><au>Wegner, Alexander</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>48</volume><issue>1</issue><spage>659</spage><epage>665</epage><pages>659-665</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Introduction
The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome.
Methods
Retrospective study of four level-1 trauma centers including all patients after major trauma with an injury severity score (ISS) ≥ 9 admitted to an intensive care unit (ICU) between 2013 and 2017. Outcome was measured using the Glasgow outcome scale (GOS).
Results
Of 4131 included patients, 95 (2.3%) had a positive screening for MDRO. Risk factors for MDRO were male gender (OR 1.73 [95% CI 1.04–2.89]), ISS (OR 1.01 [95% CI 1.00–1.03]), PRBC’s given (OR 1.73 [95% CI 1.09–2.78]), ICU stay > 48 h (OR 4.01 [95% CI 2.06–7.81]) and mechanical ventilation (OR 1.85 [95% CI 1.01–3.38]). A positive MDRO infection correlates with worse outcome. MDRO positive cases GOS: good recovery = 0.6%, moderate disability = 2.1%, severe disability = 5.6%, vegetative state = 5.7% (
p
< 0.001).
Conclusions
MDRO in severely injured patients are rare but associated with a worse outcome at hospital discharge. We identified potential risk factors for MDRO in severely injured patients. Based on our results, we recommend a standardized screening procedure for major trauma patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33221987</pmid><doi>10.1007/s00068-020-01545-4</doi><tpages>7</tpages></addata></record> |
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| subjects | Antibiotics Cohort analysis Cohort Studies Critical Care Medicine Drug resistance Drug Resistance, Multiple, Bacterial Emergency medical care Emergency Medicine Humans Incidence Intensive Male Medicine Medicine & Public Health Multidrug resistant organisms Original Article Retrospective Studies Risk Factors Sports Medicine Surgery Surgical Orthopedics Trauma Trauma centers Traumatic Surgery |
| title | Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study |
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