[Carbapenem and multidrug-resistant Acinetobacter baumannii colonisation/infection: epidemiology and factors associated with infection].

Abstract:

BACKGROUND AND OBJECTIVE:To study an outbreak of nosocomial colonisation/infection due to multidrug and carbapenem resistant A. baumannii (ABMDR-C). PATIENTS AND METHODS:Prospective study of patients with ABMDR-C colonisation/infection (January 2007-June 2008). Epidemiological and clinical variables and predictors of infection versus colonization were analysed. RESULTS:24 out of 101 cases were considered colonisations and 77 infections (27 bacteraemia); global mortality (colonisations and infections) was 42% (4 colonisations and 38 infections -18 bacteraemia). All together, the incidence was 3.2/1000 admissions/day; 29% had been previously admitted and 79% had received previous antibiotic treatment (29% carbapenem; 34% piperacillin-tazobactam; 12.5% both); 78% had an underlying condition; 81% were UCI patients; 90% had gone through invasive procedures; 65% had another microorganism isolated. In multivariate analysis, infection predictor factors were isolation of ABMDR-C in respiratory samples (OR 5.406; 95% CI 1.419-20.599); male patients (OR 8.842; 95% CI 1.988-39.325); previous hospitalization (OR 9.720; 95% CI 1.383-68.291) and initial clinical severity (OR 30.897; 95% CI 5.533-172.543). CONCLUSIONS:Our cohort of patients with ABMDR-C colonisation/infection is characterised by their underlying comorbidity, the high rate of previous invasive procedures, previous hospitalisation and previous broad-spectrum betalactam treatments (especially carbapenem). Initial severity and respiratory samples with ABMDR-C isolates were predictors of infection versus colonisation.

journal_name

Med Clin (Barc)

journal_title

Medicina clinica

authors

Hernández-Torres A,García-Vázquez E,Gómez J,Canteras M,Ruiz J,Fernández-Rufete A,Herreroa JA,Yagüe G

doi

10.1016/j.medcli.2010.01.033

subject

Has Abstract

pub_date

2010-09-18 00:00:00

pages

389-96

issue

9

eissn

0025-7753

issn

1578-8989

pii

S0025-7753(10)00512-9

journal_volume

135

pub_type

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