{"id":"https://openalex.org/W7225656986","doi":"https://doi.org/10.1186/s12879-026-14787-1","title":"Risk factors for multidrug-resistant organism infections in patients with lower respiratory tract infections: a systematic review and meta-analysis","display_name":"Risk factors for multidrug-resistant organism infections in patients with lower respiratory tract infections: a systematic review and meta-analysis","publication_year":2026,"publication_date":"2026-11-09","ids":{"openalex":"https://openalex.org/W7225656986","doi":"https://doi.org/10.1186/s12879-026-14787-1"},"language":"en","primary_location":{"id":"doi:10.1186/s12879-026-14787-1","doi":"https://doi.org/10.1186/s12879-026-14787-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14787-1","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12879-026-14787-1","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161334023","display_name":"Yong Yu","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yong Yu","raw_affiliation_strings":["Department of Laboratory, The Fifth People\u2019s Hospital of Dalian, No. 890, Huanghe Road, Shahekou District, Dalian City, Liaoning Province, 116081, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Laboratory, The Fifth People\u2019s Hospital of Dalian, No. 890, Huanghe Road, Shahekou District, Dalian City, Liaoning Province, 116081, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058232009","display_name":"Min Sun","orcid":"https://orcid.org/0000-0001-5883-0363","observed_orcids":["https://orcid.org/0000-0001-5883-0363","https://orcid.org/0009-0001-5254-4208"]},"institutions":[{"id":"https://openalex.org/I4210108983","display_name":"The Third People's Hospital of Dalian City","ror":"https://ror.org/01kr9ze74","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210108983"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Min Sun","raw_affiliation_strings":["Health Management Center, Dalian No.3 People\u2019s Hospital, Dalian City, Liaoning Province, 116091, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Dalian No.3 People\u2019s Hospital, Dalian City, Liaoning Province, 116091, China","institution_ids":["https://openalex.org/I4210108983"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102866611","display_name":"Xin Zhou","orcid":"https://orcid.org/0000-0002-7041-2647","observed_orcids":["https://orcid.org/0000-0002-7041-2647"]},"institutions":[{"id":"https://openalex.org/I191996457","display_name":"Dalian Medical University","ror":"https://ror.org/04c8eg608","country_code":"CN","type":"education","lineage":["https://openalex.org/I191996457"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xin Zhou","raw_affiliation_strings":["Department of Histology and Embryology, School of Basic Medical Sciences, Dalian Medical University, Dalian City, Liaoning Province, 116044, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Histology and Embryology, School of Basic Medical Sciences, Dalian Medical University, Dalian City, Liaoning Province, 116044, China","institution_ids":["https://openalex.org/I191996457"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5147514697","display_name":"Shiyan Qiao","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Shiyan Qiao","raw_affiliation_strings":["Department of Laboratory, The Fifth People\u2019s Hospital of Dalian, No. 890, Huanghe Road, Shahekou District, Dalian City, Liaoning Province, 116081, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Laboratory, The Fifth People\u2019s Hospital of Dalian, No. 890, Huanghe Road, Shahekou District, Dalian City, Liaoning Province, 116081, China","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5147514697"],"corresponding_institution_ids":[],"apc_list":{"value":3090,"currency":"USD","value_usd":3090},"apc_paid":{"value":3090,"currency":"USD","value_usd":3090},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10147","display_name":"Antibiotic Resistance in Bacteria","score":0.37229999899864197,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10147","display_name":"Antibiotic Resistance in Bacteria","score":0.37229999899864197,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.34689998626708984,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11681","display_name":"Nosocomial Infections in ICU","score":0.14560000598430634,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/multidrug-resistant-organisms","display_name":"multidrug-resistant organisms","score":0.9760000109672546},{"id":"https://openalex.org/keywords/lower-respiratory-tract-infection","display_name":"lower respiratory tract infection","score":0.968999981880188},{"id":"https://openalex.org/keywords/risk-factors","display_name":"risk factors","score":0.9539999961853027},{"id":"https://openalex.org/keywords/antibiotic-exposure","display_name":"antibiotic exposure","score":0.9959999918937683},{"id":"https://openalex.org/keywords/comorbidity","display_name":"comorbidities","score":0.9760000109672546},{"id":"https://openalex.org/keywords/invasive-procedures","display_name":"invasive procedures","score":0.8960000276565552},{"id":"https://openalex.org/keywords/reoperation","display_name":"reoperation","score":0.906000018119812},{"id":"https://openalex.org/keywords/neurological-disorders","display_name":"neurological disorders","score":0.8700000047683716},{"id":"https://openalex.org/keywords/stroke","display_name":"stroke","score":0.8849999904632568},{"id":"https://openalex.org/keywords/nosocomial-infections","display_name":"nosocomial infections","score":0.6150000095367432},{"id":"https://openalex.org/keywords/pneumonia","display_name":"pneumonia","score":0.3659999966621399},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.4390000104904175},{"id":"https://openalex.org/keywords/infection-control","display_name":"infection control","score":0.5950000286102295},{"id":"https://openalex.org/keywords/antimicrobial-resistance-surveillance","display_name":"antimicrobial resistance surveillance","score":0.6539999842643738},{"id":"https://openalex.org/keywords/antimicrobial-stewardship","display_name":"antimicrobial stewardship","score":0.6000000238418579},{"id":"https://openalex.org/keywords/infection-control-training","display_name":"infection control training","score":0.3019999861717224},{"id":"https://openalex.org/keywords/infection-control-compliance","display_name":"infection control compliance","score":0.33399999141693115}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.840399980545044},{"id":"https://openalex.org/C2776012195","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory tract infections","level":3,"score":0.6495000123977661},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.6200000047683716},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.5866000056266785},{"id":"https://openalex.org/C190139176","wikidata":"https://www.wikidata.org/wiki/Q598976","display_name":"Medical microbiology","level":2,"score":0.5789999961853027},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5690000057220459},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.565500020980835},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.47859999537467957},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.4474000036716461},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.42590001225471497},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.41749998927116394},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.4147000014781952},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.41029998660087585},{"id":"https://openalex.org/C2776399701","wikidata":"https://www.wikidata.org/wiki/Q3631290","display_name":"Lower respiratory tract infection","level":4,"score":0.3880000114440918},{"id":"https://openalex.org/C2776478404","wikidata":"https://www.wikidata.org/wiki/Q1105187","display_name":"Cochrane Library","level":3,"score":0.3785000145435333},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.35199999809265137},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.33009999990463257},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.3059000074863434},{"id":"https://openalex.org/C2779668873","wikidata":"https://www.wikidata.org/wiki/Q6693756","display_name":"Lower risk","level":3,"score":0.30399999022483826},{"id":"https://openalex.org/C137627325","wikidata":"https://www.wikidata.org/wiki/Q156318","display_name":"Etiology","level":2,"score":0.30079999566078186},{"id":"https://openalex.org/C2993183539","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory infection","level":3,"score":0.27570000290870667},{"id":"https://openalex.org/C2776272983","wikidata":"https://www.wikidata.org/wiki/Q7336291","display_name":"Risk of infection","level":2,"score":0.27219998836517334},{"id":"https://openalex.org/C187960798","wikidata":"https://www.wikidata.org/wiki/Q7631152","display_name":"Subgroup analysis","level":3,"score":0.26109999418258667},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.25200000405311584}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12879-026-14787-1","doi":"https://doi.org/10.1186/s12879-026-14787-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14787-1","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12879-026-14787-1","doi":"https://doi.org/10.1186/s12879-026-14787-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14787-1","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"},{"display_name":"Meta-Analysis","id":"https://openalex.org/study-designs/meta-analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W3038613999","https://openalex.org/W2372681775","https://openalex.org/W4362465782","https://openalex.org/W2356182014","https://openalex.org/W2372048402","https://openalex.org/W2766418953","https://openalex.org/W4387249424","https://openalex.org/W3158573901","https://openalex.org/W2383370591","https://openalex.org/W3030267648"],"abstract_inverted_index":{"Multidrug-resistant":[0],"organism":[1],"(MDRO)":[2],"infections":[3,17,271],"are":[4],"a":[5,193],"leading":[6],"cause":[7],"of":[8,22,47,182],"poor":[9],"prognosis":[10],"in":[11,110,272],"patients":[12,41,273],"with":[13,37,43,93,112,126,201,214,232,245,269,274],"lower":[14],"respiratory":[15],"tract":[16],"(LRTIs),":[18],"yet":[19],"systematic":[20],"evaluation":[21],"relevant":[23],"risk":[24,82,130,204,220,235,250],"factors":[25,35,78,267],"remains":[26],"insufficient.":[27],"This":[28],"study":[29],"aimed":[30],"to":[31,60,298],"systematically":[32,56],"assess":[33],"potential":[34,266],"associated":[36,125,200,231,268],"MDRO":[38,80,128,202,233,270,292],"infection":[39,81,129,203,234],"among":[40],"diagnosed":[42],"LRTIs.":[44,275],"PubMed,":[45],"Web":[46],"Science,":[48],"the":[49,106,113,179,218],"Cochrane":[50],"Library,":[51],"Embase":[52],"and":[53,79,96,105,161,185,260,290],"Scopus":[54],"were":[55,83,88,119,186],"searched":[57],"from":[58],"inception":[59],"1":[61],"March":[62],"2026.":[63],"English-language":[64],"observational":[65],"studies":[66,118,174],"reporting":[67],"associations":[68,146],"between":[69],"antibiotic":[70,183,281],"exposure,":[71,258],"comorbidities,":[72],"invasive":[73,261,287],"procedures":[74,228,262],"or":[75,294],"related":[76],"clinical":[77,195],"included.":[84,120],"Odds":[85],"ratios":[86],"(ORs)":[87],"pooled":[89],"using":[90],"random-effects":[91],"models,":[92],"subgroup,":[94],"sensitivity":[95],"publication-bias":[97],"analyses":[98],"performed.":[99],"The":[100],"review":[101],"protocol":[102],"was":[103,108],"registered(INPLASY202680075),":[104],"manuscript":[107],"reported":[109],"accordance":[111],"PRISMA":[114],"2020":[115],"statement.":[116],"Twenty":[117],"Antibiotic":[121,257],"exposure":[122,148,184,282,289],"may":[123,198,229,263],"be":[124,199,230],"increased":[127],"(OR":[131,152,164,205,221,236,251],"=":[132,140,153,159,165,171,206,212,222,237,243,252],"4.39,":[133],"95%":[134,155,167,208,224,239,254],"confidence":[135],"interval":[136],"[CI]:":[137],"2.50\u20137.71,":[138],"I\u00b2":[139,158,170,211,242],"89.9%);":[141],"subgroup":[142],"analysis":[143],"revealed":[144],"significant":[145],"for":[147],"within":[149],"30":[150],"days":[151,163],"1.38,":[154],"CI:":[156,168,209,225,240,255],"0.85\u20131.90,":[157],"0%)":[160],"90":[162],"0.87,":[166],"0.54\u20131.20,":[169],"0%).":[172],"Nine":[173],"did":[175],"not":[176],"clearly":[177],"report":[178],"time":[180],"window":[181],"therefore":[187],"interpreted":[188],"narratively":[189],"rather":[190],"than":[191],"as":[192,265],"distinct":[194],"subgroup.":[196],"Comorbidities":[197],"2.69,":[207],"2.21\u20133.27,":[210],"1.2%),":[213],"neurological":[215],"disorders/stroke":[216],"showing":[217],"highest":[219],"3.16,":[223],"1.74\u20135.73).":[226],"Invasive":[227],"7.33,":[238],"3.46\u201315.52,":[241],"82.7%),":[244],"reoperation":[246],"demonstrating":[247],"particularly":[248],"high":[249],"13.49,":[253],"6.42\u201328.36).":[256],"comorbidities":[259],"serve":[264],"Clinical":[276],"decision-making":[277],"should":[278],"integrate":[279],"recent":[280],"history,":[283],"baseline":[284],"comorbidity":[285],"status,":[286],"procedure":[288],"previous":[291],"colonisation":[293],"infection,":[295],"when":[296],"available,":[297],"support":[299],"stratified":[300],"management":[301],"strategies.":[302]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-10T00:00:00"}
