ArticleActa neurochirurgica2022
Extensively drug-resistant and multidrug-resistant gram-negative pathogens in the neurocritical intensive care unit.
Article in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 19 citations in OpenAlex.
- Epidemiology of healthcare-associated ventriculitis and meningitis (HCAVM) and community-acquired meningitis/encephalitis and evaluation of an off-label PCR panel for HCAVM diagnosis.Microbiology spectrum · 2026Article
- Development and validation of a nomogram model for predicting MDRO infections in elderly ICU patients with pulmonary infections.Aging clinical and experimental research · 2025Article
- Enhancing Safety in Regional Anesthesia: Guidelines from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).Journal of anesthesia, analgesia and critical care · 2025Review
- Post-Surgical Central Nervous System Infections in the Era of Multidrug Antibiotic Resistance in Greece-A Single-Center Experience of a Decade.Pathogens (Basel, Switzerland) · 2025Article
- Temporal Shifts in Etiological Agents and Trends in Antimicrobial Resistance of Bloodstream Infection in Southwest China from 2016 to 2023.Infection and drug resistance · 2025Article
- Multidrug-Resistant Bacteria in Immunocompromised Patients.Pharmaceuticals (Basel, Switzerland) · 2024Review
- A Difficult Case of Ventriculitis in a 40-Year-Old Woman with Acute Myeloid Leukemia.Antibiotics (Basel, Switzerland) · 2024Article
- Multidrug-Resistant and Extensively Drug-ResistantMicroorganisms · 2023Article
- Analysis on Bacterial Distribution and Change of Drug Resistance Rate in ICUs Across Southwest China from 2018 to 2022.Infection and drug resistance · 2023Article
- Treatment of Ventriculitis and Meningitis After Neurosurgery Caused by Carbapenem-ResistantInfection and drug resistance · 2023Review
- Current Perspectives on the Diagnosis and Management of Healthcare-Associated Ventriculitis and Meningitis.Infection and drug resistance · 2022Review
- Risk factors for prolonged ventilation in patients undergoing endovascular treatment of unruptured intracranial aneurysm: a retrospective cohort study.Brazilian journal of anesthesiology (Elsevier)Article
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9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbrupt increase of multidrug-resistant, extensively drug-resistant, and pandrug-resistant bacteria may complicate the course, management, and costs of neurocritical patients and is associated with high morbidity and mortality rates. No data exists regarding risk factors for colonization by gram-negative pathogens in neurocritical patients. The aim of the study was to identify risk factors associated with colonization by multidrug-resistant, extensively drug-resistant, and pandrug-resistant gram-negative bacteria in neurocritical patients.
methodsWe conducted a retrospective cohort study in a neurointensive care unit over a period of 3 years. We included adult neurocritical patients admitted for more than 48 h. We analyzed several factors including both anamnestic factors and admission diagnosis.
resultsFour hundred twenty neurocritical patients were retrospectively enrolled. Seventy-three patients developed colonization by multidrug-resistant and 53 by extensively drug-resistant gram negative pathogens. Logistic regression identified intensive care unit length of stay (LOS) as the strongest predictor for both multidrug-resistant (AUC 0.877; 95% CI 0.841-0.913) and extensively drug-resistant (AUC 0.839 0.787-0.892) gram negative pathogens. In addition, external ventricular drainage and intracerebral pressure monitoring catheter were risk factors for XDR. Survival analysis revealed that MDR bacteria colonization happens earlier (log-rank test p = 0.017).
conclusionsOptimization of healthcare strategies is required in order to reduce patients' length of stay to prevent multi- and extensively-drug gram-negative colonizations. Indeed, an early external ventricular drainage and intracerebral pressure monitoring catheter removal is deemed necessary as soon as clinically appropriate.
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