E-Locus - Institutional Repository of the University of Crete - Νοσοκομειακές λοιμώξεις από Acinetobacter στο Πανεπιστημιακό Γενικό Νοσοκομείο Ηρακλείου-παράγοντες κινδύνου,θεραπευτική αγωγή και εξέλιξη της νόσου

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Identifier

000369990

Title

Νοσοκομειακές λοιμώξεις από Acinetobacter στο Πανεπιστημιακό Γενικό Νοσοκομείο Ηρακλείου-παράγοντες κινδύνου,θεραπευτική αγωγή και εξέλιξη της νόσου

Alternative Title

Acinetobacter infection in heraklion university hospital -risk factors treatment and outcome

Author

Αριστοδήμου, Άριστος

Thesis advisor

Γκίκας, Αχιλλέας

Abstract

Acinetobacter species, mainly Acinetobacter baumannii are a major cause of hospital infections, with an increasing resistance to antibiotic treatment. This case-control study, for a specific study period recorded Acinetobacter isolations in order to draw conclusions concerning the risk factors for colonization/infection, the type of infection caused but also the mortality and the factors that affect it. The study population consisted of 74 patients and 153 controls. From the patients 62 had an Acinetobacter baumannii infection, 8 were colonized with Acinetobacter baumannii and 4 were colonized with Acinetobacter lwoffii. Patient and control mean hospitalization duration was 54 and 14 days respectively. Most infections were recorded in the Intensive Care Unit and were mainly respiratory infections (62,9%) and bacteremias (14,5%). The resistance to carbapenems was 55% and the most frequently used antibiotic for infections caused by Acinetobacter baumannii was colistin. The risk for Acinetobacter isolation was increased by the use of corticoids (OR=4,09, p=0,016), the antibiotic use during the previous year (OR=1,88, p=0,027), the presence of a central venous catheter (OR=6,48, p<0,001), the presence of an urinary bladder catheter (OR=3,23, p&llllllt;0,001), the presence of a levin (OR=4,77, p<0,001), parenteral (OR=6,26, p<0,001) and enteral feeding (OR=3,64, p<0,001), recent surgery (OR=1,93, p=0,024) or medical intervention (OR=2,77, p=0,026), intensive care unit hospitalization (OR=2,02, p=0,015), mechanical ventilation (OR=5,45, p<0,001), tracheotomy (OR=9,15, p<0,001), hemodialysis with Prisma (OR=3,58, p=0,032) and transportation from other hospitals (OR=2,91, p<0,001). 46,7% of patients with Acinetobacter baumannii infection died compared to 13,1% of the control group. A high Charlson or APACHE II score and the use of a large variety of antibiotics during the previous year were Public Health & Health Care Management Faculty of Medicine – University of Crete 4 found to increase the probability of death. The present study could lead to other more specific studies, but also increase awareness for a more rigid implementation of hospital infection control measures in PAGNI.

Language

Greek

Subject

Acinetobacter

Acinetobacter baumannii

Bacterial infections

Hospital infections

Ενδονοσοκομειακές λοιμώξεις

ΠΑΓΝΗ

Issue date

2011-04-12

Collection