title: Blood stream infections due to multidrug-resistant organisms among spinal cord-injured patients, epidemiology over 16 years and associated risks: a comparative study.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  We aimed to describe the epidemiology of multidrug-resistant organisms (MDROs) during bloodstream infection (BSI) and identify associated risks of MDROs among patients with spinal cord injury (SCI).
  
  
  METHODS
  A teaching hospital, expert center in disability, in France.
  
  
  METHODS
  We studied a retrospective cohort of all BSIs occurring in SCI patients hospitalized over 16 years. We described the prevalence of MDRO BSI among this population and its evolution over time and compared the BSI population due to MDROs and due to non-MDROs.
  
  
  RESULTS
  A total of 318 BSIs occurring among 256 patients were included in the analysis. The most frequent primary sites of infection were urinary tract infection (34.0%), pressure sore (25.2%) and catheter line-associated bloodstream infection (11.3%). MDROs were responsible for 41.8% of BSIs, and this prevalence was stable over 16 years. No significant associated factor for MDRO BSI could be identified concerning sociodemographic and clinical characteristics, primary site of infection and bacterial species in univariate and multivariate analyses. BSI involving MDROs was not associated with initial severity of sepsis compared with infection without MDROs (43.8 vs 43.6%, respectively) and was not associated either with 30th-day mortality (6.2 vs 9%, respectively).
  
  
  CONCLUSIONS
  During BSI occurrence in an SCI population, MDROs are frequent but remain stable over years. No associated risk can be identified that would help optimize antibiotic treatment. Neither the severity of the episode nor the mortality is significantly different when an MDRO is involved.
authors.affiliation: Infectious Disease Department, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Dinh
authors.affiliation: Infectious Disease Department, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Saliba
authors.affiliation: Department of Epidemiology and Biostatistics, Lebanese University, Ecole Doctorale des Sciences et Technologie, Beirut, Lebanon.
authors.forename: D
authors.initials: D
authors.lastname: Saadeh
authors.affiliation: Pharmacy, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Bouchand
authors.affiliation: Occupationnal Health Unit, EMS (Samu92), Inserm UMS011, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Descatha
authors.affiliation: Microbiology Laboratory, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: A L
authors.initials: AL
authors.lastname: Roux
authors.affiliation: Infectious Disease Department, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Davido
authors.affiliation: Intensive Care Unit, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Clair
authors.affiliation: Physical Medicine and Rehabilitation, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Denys
authors.affiliation: Intensive Care Unit, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Annane
authors.affiliation: Infectious Disease Department, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Perronne
authors.affiliation: Infectious Disease Department, R. Poincaré Teaching Hospital, 104 Bd R. Poincaré, University Hospital of Paris, Versailles St Quentin University, Paris, France.|Infectious Disease Department, Bretonneau Teaching Hospital, 2 Bd Tonnelé, University Hospital of Tours, François Rabelais University, Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Bernard
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D018709:Statistics, Nonparametric
chemical_list: D000900:Anti-Bacterial Agents