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Prevalence and predictors of multidrug resistant organism infections in critically ill patients with opioid use disorder: a multicenter retrospective cohort study
Published online by Cambridge University Press: 04 April 2025
Abstract
Objective:
Patients with Opioid Use Disorder (OUD) are prone to Multidrug-Resistant Organism (MDRO) colonization and infections, thus at risk for worse outcomes during critical illness. Understanding the prevalence and predictors of MDRO infections is essential to optimize interventions and treatments.
Design:
Retrospective cohort study.
Methods:
The study evaluated the prevalence of MDRO isolation among adults with OUD admitted to an intensive care unit (ICU) between January 1, 2018, and July 31, 2023. It included adults admitted to an ICU with bacterial infections and positive cultures obtained within 48 hours of admission. Demographics, clinical traits, and MDRO isolation rates were analyzed using descriptive statistics, univariate methods, and Least Absolute Shrinkage and Selection Operator (LASSO) regression.
Results:
MDRO isolation occurred in 178 of 790 patients (22.5%), with methicillin-resistant Staphylococcus aureus as the most frequently isolated organism. LASSO regression identified housing insecurity (OR: 1.79, 95% CI 1.09–2.93, P = .022), no receipt of medications for OUD treatment (OR: 1.56, 95% CI 1.06–2.29, P = .023), positive hepatitis C virus (HCV) status (OR: 2.19, 95% CI 1.19–4.03, P = .012), and intravenous antibiotic use in the prior 90 days (OR: 1.04 per 24 h, 95% CI 1.01–1.07, P = .007) as significant predictors of MDRO isolation.
Conclusions:
The study highlights a high prevalence of MDRO isolation in critically ill OUD patients admitted for infection-related issues with positive cultures obtained within 48 hours of admission, influenced by factors like housing insecurity, no receipt of medications for OUD treatment, HCV status, and prior antibiotic use.
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- Original Article
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- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America
Footnotes
Previous Presentation: This research was previously presented as an abstract at IDWeek 2024, held in Los Angeles, CA from Oct. 16–19, 2024. The findings shared in this manuscript build upon and expand the preliminary data presented in that abstract, incorporating additional analysis and discussion to provide a more comprehensive understanding of the study’s outcomes.
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Rizwan et al. supplementary material
Rizwan et al. supplementary material
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