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Risk factors for hospital-acquired Acinetobacter baumannii bacteraemia

Abstract number: R2253

Bulut C., Ataman Hatipoglu C., Yetkin M.A., Ertem G., Yilmaz G.R., Ozisik A., Karakoc E., Demiröz A.P.

Objectives: Acinetobacters are increasingly detected as aetiological agents of hospital acquired infections in seriously ill patients, in recent years. The aim of this study was to evaluate risk factors for Acinetobacter baumannii bacteraemia.

Methods: Prospective laboratory-based active surveillance has been performed in our hospital. Hospital acquired A. baumannii infections detected between January 2005 and December 2006 were enrolled to the study. The definitions of hospital acquired infections were established by using CDC criteria. Conventional methods were used to identificate Acinetobacter isolates. Disc diffusion method was used for antimicrobial susceptibility testing of these microorganisms.

Results: Total of 117 A. baumannii infections were included in the study. These infections were detected in 58 male and 59 female patients. The mean age of the patients was 59±19 years. A. baumannii was isolated most commonly from the neurosurgery intensive care unit (ICU) (30%), followed by neurology ICU (22%) and internal medicine wards (12%). Of the isolates, 28.5% were isolated from pneumonia, 22% from primary bacteraemia, 21.5% from surgical site infections, 20.4% from urinary tract infections and 7.6% from other infections. Predisposing factors detected in the patients with A. baumannii infection were urinary catheter (81.3%), central venous catheter (41%), mechanical ventilation (30%) and tracheotomy (15%). The rate of the patients who had coma was 46%. The mean duration of time between hospitalisation and occurrence of infection was 18±15 (3–108) days. In seventy patients (57%) A. baumannii isolates were multi-drug resistant (MDR).

A. baumannii bacteraemia was detected in 51 episodes. Bacteraemia and other infections due to A. baumannii were compared. Male gender, insertion of urinary catheter, presence of central venous catheter, presence of peripheric arterial catheter, mechanical ventilation, total parenteral nutrition and being an ICU patient were found as risk factors for A. baumannii bacteraemia (p < 0.05). On multivariate analyses only mechanical ventilation was found as a risk factor (p < 0.05).

Conclusions: In ICUs, patients with mechanical ventilation, urinary catheter, central venous catheter, total parenteral nutrition are at risk for A. baumannii bacteraemia. High mortality rate and antibiotic resistance of these microorganisms are still important problems.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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