Risk factors for nosocomial Acinetobacter bacteremia: a case-control study of intensive care unit patients
Journal Title: Journal of Microbiology and Infectious Diseases - Year 2013, Vol 3, Issue 4
Abstract
Objective: This study was performed to identify risk factors and to determine the attributable mortality and clinical outcomes of nosocomial Acinetobacter bacteremia in our intensive care unit. Methods: A retrospective case-control (1:1) study was conducted in a tertiary, academic hospital composed of 300 beds. The control group consisted of 54 consecutive patients with negative blood cultures, matched by sex, age (±10 years), primary and secondary diagnosis, operative procedures, and date of admission. Results: There was a trend for a longer median duration of hospitalization among the patient group compared with the control group (25.0 versus 8.0 days; p=0.001). Patients with Acinetobacter bacteremia had significantly more hemodynamic instability (hypoxia, shock) (p=0.001). We detected that the presence of risk factors such as mechanical ventilation, central venous catheter, anemia, thrombocytopenia, hypoalbuminemia and impairment in creatinine clearance was higher in the patient group than in the control group (p<0.004). Thirty-three (61.1%) of the cases died whereas 14 (25.9%) of the controls died (p=0.001). The attributable mortality was estimated as 35.2%. Of the 54 Acinetobacter isolates, 44 (81.5%) were resistant to two or more different antibiotic classes. Conclusion: In critically ill patients, Acinetobacter bacteremia is associated with a significantly increased mortality rate. Central venous catheter insertion, mechanical ventilation, long length of hospital stay and concomitant metabolic disease were risk factors for the presence of bacteremia. J Microbiol Infect Dis 2013;3(4): 157-162 Key words: Acinetobacter spp., intensive care unit, nosocomial bacteremia
Authors and Affiliations
Özlem Tunger, Gönül Keleş, Şebnem Şenol S, Çiğdem Çetin, Horu Gazi, Sümeyra Çoban S, İlkay Aras, Melek Çivi
The prevalence of HIV and the role of immigration in Albania
Objective: International migration is an increasingly important aspect of global, regional and national economies. The rapid spread of HIV among communities, states and continents, is the evidence of the link betwee...
The incidence of fungal keratitis in Zagazig University Hospitals, Egypt and the value of direct microscopy and PCR technique in rapid diagnosis
Objective: To determine the frequency and risk factors of fungal keratitis (FK) and the value of direct microscopy and PCR techniques of corneal smears as appropriate diagnostic methods. Methods: The keratitis cases in...
Brusella spondilodiskiti: Torasik ve lomber bölgenin multifokal tutulumu; nadir bir olgu
Brusellozis bir çok organ ve dokuları tutabilen bir zoonotik enfeksiyondur. İskelet sistemi bruselloziste en sık etkilenen bölge olup, sıklığı % 2 ile % 53 arasında değişmektedir. Multifokal spinal tutulum nadirdir....
Treatment of Mucormycosis with Liposomal Amphotericin B, Posaconazole and Deferasirox: A Case Report
In this paper, we present a 69 years old diabetic patient with mucormycosis who was succesfully treated with liposomal amphotericin B (LAMB), posaconazole and deferasirox despite having no adequate surgery. Th...
Miyelodisplastik sendromlu bir hastada Campylobacter fetus subsp. fetus ’e bağlı bir bakteriyemi: Olgu sunumu
Campylobacter fetus immün yetmezliği olan hastalarda bağırsak dışı enfeksiyonların önemli bir etkenidir. Bu çalışmada miyelodisplastik sendromlu bir hastada C. fetus subsp. fetus’e bağlı bir bakteriyemi olgusu sunuldu. M...