Feasibility Study on Risk Stratification for Multidrug-Resistant Organism Infections Among ICU Patients in the United Arab Emirates

Purpose: Global MDRO risk prediction tools are less applicable in UAE due to the variety in health profiles across all health sectors. Tools built using risk factors based on demographic structure of the country are more clinically applicable. This pilot retrospective case-control study aimed to identify potential risk factors associated with MDRO infections among critically ill patients in a UAE tertiary hospital and to assess the feasibility of conducting a larger-scale study for the future development of an empirical antibiotic selection tool. Patients and Methods: Data were collected from a tertiary care academic hospital in Sharjah. Patients admitted to the ICU for more than 24 hours for a hospital-acquired infection between March to May 2022 were included. A total of 39 patients profiles were screened through random sampling. Potential risk factors for MDRO infections were identified. Student’s t -test, Kruskal–Wallis test, and Chi-square test, all used wherever applicable at alpha = 0.05. Results: Collected patient profiles were divided into three groups: MDRO (n = 11), Non-MDRO (n = 10), and no-growth (n = 18). Preliminary risk factors, such as history of bacterial growth was identified to put patients at 2.83 folds of risk of getting MDRO infection ( 95% CI 1.489– 5.39 ). Patients who required enteral tube feeding had a 2.22 higher risk (95% CI 1.369– 3.608). Moreover, the de-escalation of antibiotics was statistically significant ( p = < 0.001) and higher in the MDRO group versus non-MDRO with 81.8% (n = 9) and 60% (n = 6), respectively. Conclusion: This study provides preliminary insights into potential risk factors for MDRO infections in ICU of UAE population, such as the need for tube feeding and tracheostomy. The study successfully demonstrated the feasibility of data collection and stratification of patients. The observed trends support the need for a larger, adequately powered study to validate these risk factors and to facilitate the development of a predictive risk assessment tool. Keywords: antimicrobial resistance, risk assessment tool, epidemiological factors, critical care, antibiotic stewardship, UAE