Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
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چکیده
BACKGROUND Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU. METHODS We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009. RESULTS Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; P = 0.035, 22.9 vs. 16.8; P < 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; P = 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; P = 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; P = 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia. CONCLUSIONS Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia.
منابع مشابه
Antimicrobial Resistance Pattern of Acinetobacter baumannii Strains Isolated from Intensive Care Unit Patients
ABSTRACT Background and Objectives: Acinetobacter baumannii is an opportunistic pathogen that affects different groups of people, especially intensive care unit (ICU) patients. The prevalence of infections caused by this bacterium is very high. Today, prevalence of infections caused by multidrug-resistant (MDR) and extreme-drug resistant (XDR) strains is increasing. This study aime...
متن کاملAuthor's response to reviews Title: Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit Authors:
Ji Ye Jung ([email protected]) Moo Suk Park ([email protected]) Song Ee Kim ([email protected]) Byung Hoon Park ([email protected]) Ji Young Son ([email protected]) Eun Young Kim ([email protected]) Joo Eun Lim ([email protected]) Sang Kook Lee ([email protected]) Sang Hoon Lee ([email protected]) Kyung Jong Lee ([email protected]) Young Ae Kang ([email protected]) Se Kyu Kim ([email protected]) Joon Chang (chang@yuhs...
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