Multidrug-resistant infections in ICU trauma patients: Incidence and prognostic implications
Abstract
Background: The increasing prevalence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) organisms in the ICU has raised concerns regarding their impact on clinical outcomes in critically ill trauma patients. For this study, MDR, XDR, and PDR were defined according to the international consensus by Magiorakos et al. (2012): MDR = non-susceptibility to ≥3 antimicrobial classes; XDR = non-susceptibility to all but one or two classes; PDR = non-susceptibility to all agents in all classes. This study investigates the correlation between microbial resistance and severity indicators, length of stay, and patient outcomes.
Method and Material: A prospective observational study was conducted in a single-center ICU, including adult patients admitted due to severe trauma. Demographic data, clinical scores (SOFA, APACHE II, ISS), presence of MDR/XDR/PDR colonization or infection (defined using CDC/NHSN criteria), duration of mechanical ventilation and hospitalization, and patient outcomes were recorded and analyzed using appropriate statistical methods.
Results: Μultidrug resistant pathogens were frequently encountered in this trauma ICU cohort and were associated with significantly worse clinical outcomes. Age and BMI were associated with mortality in bivariate analyses; however, these findings should not be interpreted as independent risk factors in the absence of multivariable adjustment. Sex, smoking status, and ARDS did not show significant associations.
Conclusions: The presence of multidrug resistant infections represents a substantial clinical burden in critically ill trauma patients and was linked to worse outcomes in this cohort. These findings highlight the clinical importance of early detection, optimized antimicrobial stewardship, and careful management in this vulnerable population. Given the very small sample size for PDR cases, these findings should be interpreted with caution. Despite the significant associations identified, the study’s limitations—including the small sample size, single-center design, lack of long-term follow-up, and absence of time-dependent or multivariable analyses—warrant cautious interpretation. Future multicenter and longitudinal studies are needed to further investigate resistance mechanisms, optimize therapeutic strategies, and reduce bias in outcome attribution.
Article Details
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Tsimpidis, A., Kipourgos, G., Toulia, G., & Pavlatou, N. (2026). Multidrug-resistant infections in ICU trauma patients: Incidence and prognostic implications. Health & Research Journal, 12(2), 89–102. https://doi.org/10.12681/healthresj.42103
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