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.
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