The incidence and risk factors for Acinetobacter baumannii bacteraemia in ICU patients with A. baumannii respiratory tract colonisation
Abstract number: 1134_04_149
Pratikaki M., Platsouka E., Routsi C., Sotiropoulou C., Kritikos K., Belessiotou H., Paniara O., Roussos C.
The aim of the study was to determine the impact of Acinetobacter baumannii respiratory tract colonization in patients admitted to the ICU, and the incidence and the risk factors for the development of A. baumannii bacteraemia in this group of patients.
During a 4-month period all patients with ICU stay more than 48 hours, in the 30-bed multidisciplinary ICU of Evangelismos hospital, were studied. Clinical, laboratory, and demographic characteristics, the time of respiratory tract colonization with A. baumanni, the development of A. baumannii bacteraemia, and the susceptibility profiles were recorded.
During the study period 63 (44 male, 19 female), of the 152 ICU patients, (41%), became respiratory tract colonized with A. baumannii. Admission diagnosis was surgical in 35 of them and medical in the remaining 28. Subsequently, 20 of the above group of patients (32%) developed A. baumannii bacteraemia. The time between admission and colonization or bacteraemia was 6.5 days and 10.5 days respectively (median value). All A. baumannii strains were resistant to aminoglycosides and 20.6% of them were resistant to ampicillin plus sulbactam. Patients with A. baumannii respiratory tract colonization who developed A. baumannii bacteraemia had significantly a higher Apache II score on admission than those with A. baumannii respiratory tract colonization who didn't developed A. baumannii bacteraemia (22.2 + 1.7 vs. 17.2 + 1.0, p = 0.014). Multiple logistic regression analysis showed that independent risk factors for A. baumannii bacteraemia in the respiratory track colonized patients with A. baumannii, were Apache II score (OR = 1.1, p < 0.05), and admission albumin (OR = 0.3, p = 0.03).
The incidence of A. baumannii bacteraemia in the ICU patients with A. baumannii respiratory tract colonization is high (32%). The severity of the disease and the degree of hypoalbuminaemia on admission are independent risk factors for the development of A. baumannii bacteraemia in ICU patients with A. baumannii respiratory tract colonization.
|Session name:||XXIst ISTH Congress|
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