Skip to content
DraconiticResearch
Search Sources API
197,761 studies31 sourcesUpdated 27 min ago
Peer-reviewedCC BY 4.0Infection

Impact of colonisation with multidrug-resistant gram-negative bacteria in a low endemicity setting: a population-based observational study

  • Vigith Andrews1,2
  • Erik Senneby3,4
  • Malin Inghammar3,2
  • Oskar Ljungquist2,5
5 affiliations
  1. 1Clinical Microbiology, Infection Prevention and Control, Office for Medical Services, Region Skåne, 22185 Lund, Sweden
  2. 2Section for Infection Medicine, Department of Clinical Sciences Lund, Lund University, 22242 Lund, Sweden
  3. 3Department of Infection Prevention and Control Region Skåne, Skåne University Hospital, 22185 Lund, Sweden
  4. 4Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
  5. 5Department of Infectious Diseases, Helsingborg Hospital, 25187 Helsingborg, Sweden
Read full textPDFDOICite

Abstract

Purpose: The health impact of multidrug-resistant gram-negative bacilli (MDR-GNB) colonisation in low-endemic settings remains insufficiently characterised. We aimed to evaluate mortality and healthcare utilisation associated with MDR-GNB colonisation in a Swedish population identified through targeted screening following universal risk assessment.

Methods: All patients screened for MDR-GNB in Skåne, Sweden, between 2013 and 2022, were included, with one year of follow-up. Data on mortality (primary outcome), and secondary outcomes, including emergency department (ED) visits and hospital admissions, outpatient visits and antibiotic prescriptions, were extracted from health records. Logistic regression and Cox proportional hazards models were applied to compare patients with and without MDR-GNB colonisation, with odds ratio (OR) and hazard ratios (HR) quantifying associations.

Results: Among 12,901 screened patients, 2,485 (19%) had colonisation with extended-spectrum β-lactamase–producing Enterobacterales, 83 (0.6%) with carbapenemase-producing Enterobacterales, 50 (0.4%) with carbapenem-resistant Acinetobacter spp. and 21 (0.2%) with carbapenem-resistant Pseudomonas aeruginosa. The overall one-year mortality was 6.6%, with no association between MDR-GNB colonisation and mortality (HR 0.96, 95% CI 0.80–1.14). MDR-GNB colonisation was, however, associated with increased risk of ED visits and hospital admissions, longer hospital stays, ICU-admissions, increased use of ambulatory and primary care, and higher antibiotic prescribing. These associations were most pronounced within the first three months post-screening and declined thereafter.

Conclusions: Although MDR-GNB colonisation did not increase one-year mortality risk, patients with colonisation experienced significantly increased healthcare use. Further research is warranted to optimise patient outcomes, including preventive measures, and healthcare resource utilisation in this population.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02878-9.

Related

  1. Prevalence and Antimicrobial Susceptibility Patterns of Multidrug-resistant Organisms: A Retrospective Observational Study from a Tertiary Care Hospital
    Charmi Mangal, Payal Khant, Kairavi Passwala +2
    Journal of Clinical and Diagnostic ResearchPeer-reviewedCC BY-NC-NDFull textGeneral medicineDOAJ
  2. Emergence of vancomycin-resistant and multidrug-resistant Enterococcus spp. in freshwater aquaculture systems of southeastern Nigeria: implications for one health surveillance
    Chidimma Onyinye Ikeme, Leatitia Ugochinyere Igwe, Chukwuebuka Nnamdi Onwubuariri
    Brazilian Journal of MicrobiologyPeer-reviewedLicence not statedFull textGeneral medicinePMC
  3. Challenges of Using a Bedaquiline-Based Regimen to Treat Multidrug-Resistant Tuberculosis in Pregnancy
    Open forum infectious diseasesPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  4. A rare case report of Rasmussen’s aneurysm in multidrug-resistant tuberculosis from Nepal
    Aashish Lamichhane, Apil Pokhrel, Sadish Sharma +1
    Annals of medicine and surgery (2012)Peer-reviewedCC BYFull textGeneral medicineEurope PMC
  5. Phenotypic Characterization of Multidrug-Resistant Pseudomonas aeruginosa Isolated From Patients With Ventilator-Associated Pneumonia: Insights Into Resistance Mechanisms and Biofilm Formation
    Sneha D Parit, Priyanka M Mane, Satish R Patil
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{andrews2026impact,
  title = {{Impact of colonisation with multidrug-resistant gram-negative bacteria in a low endemicity setting: a population-based observational study}},
  author = {Vigith Andrews and Erik Senneby and Malin Inghammar and Oskar Ljungquist},
  journal = {Infection},
  year = {2026},
  month = jul,
  doi = {10.1007/s15010-026-02878-9},
  url = {https://doi.org/10.1007/s15010-026-02878-9},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Impact of colonisation with multidrug-resistant gram-negative bacteria in a low endemicity setting: a population-based observational study
AU  - Vigith Andrews
AU  - Erik Senneby
AU  - Malin Inghammar
AU  - Oskar Ljungquist
PY  - 2026
DA  - 2026/07/15
JO  - Infection
DO  - 10.1007/s15010-026-02878-9
UR  - https://doi.org/10.1007/s15010-026-02878-9
AB  - Purpose: The health impact of multidrug-resistant gram-negative bacilli (MDR-GNB) colonisation in low-endemic settings remains insufficiently characterised. We aimed to evaluate mortality and healthcare utilisation associated with MDR-GNB colonisation in a Swedish population identified through targeted screening following universal risk assessment.  Methods: All patients screened for MDR-GNB in Skåne, Sweden, between 2013 and 2022, were included, with one year of follow-up. Data on mortality (primary outcome), and secondary outcomes, including emergency department (ED) visits and hospital admissions, outpatient visits and antibiotic prescriptions, were extracted from health records. Logistic regression and Cox proportional hazards models were applied to compare patients with and without MDR-GNB colonisation, with odds ratio (OR) and hazard ratios (HR) quantifying associations.  Results: Among 12,901 screened patients, 2,485 (19%) had colonisation with extended-spectrum β-lactamase–producing Enterobacterales, 83 (0.6%) with carbapenemase-producing Enterobacterales, 50 (0.4%) with carbapenem-resistant Acinetobacter spp. and 21 (0.2%) with carbapenem-resistant Pseudomonas aeruginosa. The overall one-year mortality was 6.6%, with no association between MDR-GNB colonisation and mortality (HR 0.96, 95% CI 0.80–1.14). MDR-GNB colonisation was, however, associated with increased risk of ED visits and hospital admissions, longer hospital stays, ICU-admissions, increased use of ambulatory and primary care, and higher antibiotic prescribing. These associations were most pronounced within the first three months post-screening and declined thereafter.  Conclusions: Although MDR-GNB colonisation did not increase one-year mortality risk, patients with colonisation experienced significantly increased healthcare use. Further research is warranted to optimise patient outcomes, including preventive measures, and healthcare resource utilisation in this population.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02878-9.
SN  - 0300-8126
SN  - 1439-0973
ER  -