Risk factors for hospital infections caused by carbapanem-resistant Acinetobacter baumannii

Abstract

Introduction: Acinetobacter baumannii is one of major causative agents of severe, life-threatening hospital infections (HIs), especially in intensive care units (ICUs). Our aim was to discover the risk factors associated with the emergence of HIs caused by carbapenem-resistant Acinetobacter baumannii (CRAB), as well as those associated with death in patients who suffer from such infections. Methodology: A prospective cohort study was conducted over a five-year period in the medical-surgical ICU of the Clinical Centre in Kragujevac, Serbia. The study group comprised patients who had HIs caused by CRAB, while the control group comprised patients infected with carbapenem-sensitive Acinetobacter baumannii. Results: In total, 137 patients developed HIs caused by Acinetobacter baumannii. The mean age of the patients was 59.65 ± 16.08 years, and 99 (72.26%) of them were males. In 95 patients (69.35%), the infection was caused by CRAB. There were six independent risk factors for CRAB infections: use of mechanical ventilation, previous stay in another department, stay in ICU for more than a month, and previous use of carbapenems, aminoglycosides, and metronidazole. Three independent risk factors were found for death in patients with HIs caused by CRAB: use of mechanical ventilation, previous stay in another department, and previous use of carbapenems. Conclusions: The results of this study can be helpful when identifying patients with risk of HIs caused by CRAB and in planning preventive measures. Modification of known risk factors and appropriate institutional policy of antibiotic utilization are important measures that may decrease the incidence and mortality of such infections.

Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit

“…Similar results were reported by Djordjevic et al among adult patients admitted to a medical-surgical ICU. 24 This study is subject to certain limitations. Generally, NICUs in developing countries such as Egypt usually have low staff-to-patient ratios, often resulting in a lack of essential infection control precautions like thorough hand hygiene and aseptic procedures.…”

Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

“…As mentioned above, A. baumanni has propensity to tolerate stressful environments and multiple classes of antibiotics, making it able to survive and spread as a nosocomial pathogen, particularly in critically ill patients, contributing to increased morbidity and mortality [22]. Previous studies addressing risk factors for acquisition of A. baumannii have reported multiple culprits including long ICU stay, previous hospital or ICU stay, previous antimicrobial therapy, mechanical ventilation, use of devices (indwelling catheters, endotracheal tube or nasogastric tube), older age, major or emergent surgery, low birth weight or prematurity, dialysis, and prolonged use of total parenteral nutrition or intravenous lipids [23][24][25][26]. In recent years, A. baumannii infections involving respiratory tract, bloodstream, skin and soft tissue, urinary tract, and central nervous system have emerged as highly problematic in healthcare institutions.…”

A systematic review and expert’s analysis of risk factors of infections in adults due to carbapenem-resistant Pseudomonas aeruginosa or Acinetobacter baumannii in Spain

“…Los FR considerados poco importantes (Tabla 3), presentan menor evidencia y número de estudios que demuestren su asociación con las infecciones por microorganismos RC. De las 19 variables de este grupo, solamente 3 están asociadas a las infecciones por microorganismos RC entre 2015-2020 [17][18][19].…”