Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives

Table 1 Risk factors for acquiring multi-drug resistant bacteria

Category	Risk factor
Healthcare-associated	Prolonged hospitalization (especially in ICU). Recent surgery or invasive procedures. Use of medical devices (catheters, ventilators, central lines). Residence in long-term care facilities. Frequent hospital admissions or outpatient visits. Hemodialysis or chronic outpatient treatments
Antibiotic exposure	Prolonged use of broad-spectrum antibiotics. Inappropriate or incomplete antibiotic courses. Over-the-counter or self-medicated antibiotic use
Patient-related	Immunocompromised status (e.g., cancer, HIV, transplants). Chronic illnesses (e.g., diabetes, COPD, renal failure). Extremes of age (infants and elderly). Malnutrition. Gut dysbiosis due to prolonged gastric acid suppression
Environmental/community	International travel to high MDR prevalence regions. Contact with infected or colonized individuals. Poor sanitation or overcrowded living conditions

ICU: Intensive care unit; HIV: Human immunodeficiency virus; COPD: Chronic obstructive pulmonary disease; MDR: Multi-drug resistant.