ORIGINAL RESEARCH article
Front. Physiol.
Sec. Integrative Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1658683
Analysis of the etiological characteristics of multidrug-resistant organisms and prognostic factors in ICU patients
Provisionally accepted
- 1Baogang Hospital of Inner Mongolia, Baotou, China
- 2The 969th Hospital of PLA, Hohhot, China
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Background: Multidrug-resistant organism (MDRO) infections contribute to high mortality in intensive care unit (ICU) patients, yet their specific pathogen profile and mortality risk factors are inadequately characterized. Objective: This study aims to investigate MDRO infections in ICU patients, identify prevalent pathogens, and evaluate risk factors associated with 28-day mortality. Methods: A retrospective study of 260 ICU patients with MDRO infections (resistant to ≥ 3 antimicrobial classes) analyzed specimen types, infection sites, and pathogens. Patients were grouped (survival group and non-survival group) by 28-day survival outcomes. Multivariate Logistic regression identified prognostic factors, and the model’s validity, fit, and discriminatory power were assessed. Results: In ICU patients with MDRO infections, sputum was the most common test specimen, with the respiratory system as the main infection site. Pathogenic bacteria primarily included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Sixty-seven patients died within 28 days after enrollment (mortality rate: 25.77%). ICU length of stay (OR: 1.141; 95%CI: 1.020-1.275), APACHE II score upon admission (OR: 1.496; 95%CI: 1.261-1.775), comorbidity with cardiovascular and cerebrovascular diseases (OR: 4.620; 95%CI: 1.665-12.821), comorbidity with pulmonary diseases (OR: 4.150; 95%CI:1.722-10.000), duration of mechanical ventilation > 7 days (OR: 3.457; 95%CI: 1.502-7.955), and number of invasive procedures (OR: 1.845; 95%CI: 1.239-2.748) were independent risk factors for poor prognosis in ICU patients with MDRO infections. A Logistic regression equation was developed: Logistic Regression Equation = -20.646 + 0.132X1 (ICU stay) + 0.403X2 (APACHE II score) + 1.530X3 (cardiovascular/cerebrovascular comorbidities) + 1.423X4 (pulmonary comorbidities) + 1.240X5 (mechanical ventilation >7 days) + 0.613X6 (invasive procedures). The model was statistically significant (Likelihood ratio chi-square test, P < 0.05) and demonstrated good fit (Hosmer-Lemeshow test, P > 0.05). The area under the AUC was 0.913 (0.85 ≤ AUC < 0.95), with 65.67% sensitivity, 93.78% specificity, and 86.54% accuracy in predicting survival/death risk in MDRO-infected patients, indicating strong discriminatory power. Conclusion: ICU patients with MDRO infections exhibit diverse pathogens. Prompt preventive and control measures should be taken based on the characteristics of MDRO infections and high-risk factors associated with prognosis to reduce the risk of death following MDRO infections.
Keywords: Multidrug-resistant organism, Intensive Care Unit, pathogenic characteristics, Poor prognosis, Influencing factors
Received: 03 Jul 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Du, Ji, Li, Jia and Xi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ruiping Xi, The 969th Hospital of PLA, Hohhot, China
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