Observational studyInternal and emergency medicine2025
Bloodstream infections due to multi-drug resistant bacteria in the emergency department: prevalence, risk factors and outcomes-a retrospective observational study.
Observational study in Internal and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- A practical nomogram for predicting multidrug-resistant organism infection in a tertiary county-level hospital to guide antimicrobial therapy.New microbes and new infections · 2026Article
- ESKAPE Pathogens in a Hungarian Emergency Department: A 5-Year Retrospective Observational Study of Prevalence and Resistance Patterns Utilizing the AWaRe Framework.Antibiotics (Basel, Switzerland) · 2026Article
- Association of Once-Daily MALDI-TOF MS Identification with Antibiotic Appropriateness and First-Modification Patterns in Emergency Department Bacteremia: A Retrospective Before-After Cohort Study.Antibiotics (Basel, Switzerland) · 2026Article
- [Risk factors associated with inadequacy of empirical treatment in patients with sepsis and bacteremia attended in an emergency department].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Observational
- Machine learning-based prediction of carbapenem-resistantFrontiers in pharmacology · 2026Article
- Article
- A multidimensional nomogram for clinical risk stratification of bloodstream infection and mortality in hematologic malignancies.Frontiers in cellular and infection microbiology · 2026Article
- Article
- Comparison of VITEK REVEAL fast antimicrobial susceptibility testing to antibiotic disk diffusion for gram-negative bloodstream infections.Journal of clinical microbiology · 2025Article
- Impact of antibiotic post-prescription authorization in resource-limited emergency rooms and acute care units during the COVID-19 pandemic.BMC emergency medicine · 2025Observational
- Microbial Multidrug-Resistant Organism (MDRO) Mapping of Intensive Care Unit Infections.Medicina (Kaunas, Lithuania) · 2025Observational
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multidrug-resistant organisms (MDROs) are prevalent in patients admitted to the Emergency Department (ED) and increase the risk of inappropriate empirical antibiotic therapy. Risk stratification for MDRO infection is essential to early identify patients requiring empirical broad-spectrum antibiotic therapy, but it remains challenging for emergency physicians. This study aimed to evaluate prevalence, risk factors, and outcomes of patients admitted to the ED with a bloodstream infection (BSI) caused by MDROs. A retrospective observational study enrolling all consecutive adult patients admitted with a BSI to the ED of Niguarda Hospital, Italy, from January 2019 to December 2021 was performed. 757 patients were enrolled, 14.1% with septic shock. 156 (20%) patients had a BSI caused by MDRO: extended-spectrum beta-lactamase (ESBL) producing Enterobacterales were the most prevalent followed by methicillin-resistant Staphylococcus aureus (MRSA). Risk factors for BSI due to MDRO and specifically for ESBL were chronic renal failure (OR 2.2; 95%CI 1.4-3.6), nursing home residency (OR 4.4; 95%CI 1.9-10.2) and antibiotic therapy in the last 90-days (OR 2.6; 95%CI 1.7-4), whereas for MRSA were dialysis (OR 12.3; 95%CI 1.8-83), antibiotic therapy and/or hospital admission in the past 90-days (OR 3.6; 95%CI 1.2-10.6) and ureteral stent or nephrostomy (OR 7.8; 95%CI 1.5-40.9). Patients with BSI due to MDRO had a higher rate of inappropriate empirical antibiotic therapy (50%) and longer length of stay, but no higher in-hospital mortality. Among patients admitted to the ED with a BSI, MDROs are frequent and often associated with inappropriate empirical antibiotic therapy. Specific updated risk factors for MDRO may help clinicians to better identify patients requiring a broader antibiotic therapy in the ED, while awaiting microbiological results.
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