Characteristics of pathogenic microorganisms in intensive care units and development of a mortality risk scoring tool for critically infected patients: A Retrospective Study from Shanxi, China

Abstract

Abstract Background Global concern surrounds high intensive care unit (ICU) mortality rates from pathogenic microorganism infections, particularly multidrug-resistant (MDR) bacteria. These infections significantly impact patient treatment outcomes and quality of life. This study aims to survey microbial epidemiology in ICU patients, explore death risk factors in severe infections, and establish a mortality risk scoring model. Methods A retrospective cohort study in an ICU analyzed epidemiological characteristics, microbial profiles, antimicrobial susceptibility, and patient mortality risk. Mortality risk factors were classified using univariate and multivariate analyses. The model's calibration was internally validated and its discrimination determined by the Area under the Receiver Operating Characteristic curve (AuROC). Results Between January 1, 2020, and December 31, 2021, a total of 952 patients were enrolled with infections caused by microorganisms. From these patients, 1713 pathogenic microorganisms were isolated in total. The identified microorganisms included 451 gram-positive bacteria, 1140 gram-negative bacteria, 117 funguses, and 5 other protists. Among them are 646 strains of MDR bacteria. A scoring model was developed, which included factors such as infection with MDR bacteria, cardiopulmonary resuscitation (CPR), total bilirubin (TBLT), creatinine clearance (CCr), tumor, Gout & mixed connective tissue disease (MCTD), and disorders of consciousness. The performance of the model was evaluated and showed good discrimination and calibration. Conclusion This study analyzed the prevalence of pathogenic microorganism in the ICU of hospital and explored their risk factors with patient mortality. The Bacteriology profile and antimicrobial susceptibility of MDR bacteria were explored. A simplified predictive scoring tool was established to predict patient mortality with infections in ICU. The study highlights the importance of monitoring and predicting the mortality risk associated with pathogenic microorganism infections in ICUs.