The relationship between patient characteristics and the development of a multi-resistant healthcare-associated infection in a private South Australian hospital
L. S. Jarratt A B and E. R. Miller A
+ Author Affiliations
- Author Affiliations
A School of Population Health, The University of Adelaide, SA 5005, Australia.
B Corresponding author. Email: ljarratt@stand.org.au
Healthcare Infection 18(3) 94-101 https://doi.org/10.1071/HI13010
Submitted: 22 February 2013 Accepted: 16 April 2013 Published: 28 May 2013
Journal Compilation © Australasian College for Infection Prevention and Control 2013
Abstract
Background: The prevention of healthcare-associated infections (HAI) and the rise of multi-resistant organisms are significant public health issues. Infections caused by multi-resistant organisms (MRO) can have similar clinical manifestations to infections caused by non-multi-resistant organisms (non-MRO HAI) but antibiotic treatment options are more limited, which can result in treatment failure. This study aimed to reduce the incidence of MRO HAI in a specific South Australian hospital setting by identifying factors that are associated with MRO transmission.
Methods: Using a case-control design, we analysed data from 1017 adult patients who developed an HAI in the 9-year period from 2003 to 2011 in a private South Australian hospital. We compared risk factors in patients who developed MRO HAI (cases) with risk factors in patients who developed non-MRO HAI (controls). Data were collected from the hospital’s patient management database and individual medical records, and analysed using univariate and multivariate techniques.
Results: Independent predictors for the development of MRO HAI were the presence of an indwelling urinary catheter and renal disease. The development of a secondary infection was significantly more likely in MRO relative to non-MRO HAI, as was secondary bloodstream infection following a primary urinary tract infection.
Conclusion: All effective interventions for reducing MRO, specifically in UTI, should be implemented where feasible. Increased healthcare worker education on aseptic non-touch technique, and safe insertion and management of an IDC, particularly important in patients with underlying renal disease, could assist in decreasing the risk of MRO HAI in this setting.
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