Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis

Abstract

To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A. baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11-3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001).

Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections

“…[3] Recent studies have had mixed results to indicate mortality attributable of Acinetobacter. Some authors reported increased mortality rates secondary to Acinetobacter [19] while others including ours found not. [20] A. baumannii isolates common with relatively higher MDR rates may be due to habits of frequent prescribing or using wide spectrum antimicrobials in our country.…”

Patterns of Antimicrobial Resistance Among Intensive Care Unit Patients of A Private Medical College Hospital in Dhaka

“…have emerged as important pathogens of ICUs, most of them being resistant to ampicillin, carbenicillin, cefotaxime, chloramphenicol, and gentamicin. 7,8 In our study, Acinetobacter spp was the number one cause of pneumonia based on samples gathered from the tracheal aspirate and shows resistance to ceftriaxone (85.1%), ceftazidime (88.8%), amikacin (86.2%), gentamicin (84.4%) and fluoroquinolones (86.2-89.2%) respectively. This is consistent with the results of a similar study conducted in India.…”

Multidrug resistant Acinetobacter baumannii--the role of AdeABC (RND family) efflux pump in resistance to antibiotics.

“…Acinetobacter baumannii is the species most often responsible for a wide spectrum of nosocomial infections [68,113,136]. It is infections such as bloodstream infections, ventilator-associated pneumonia, urinary tract infections and wound infections [113,124,129,136].…”