Risk factors and impact of nosocomial Acinetobacter baumannii bloodstream infections in the adult intensive care unit: a case–control study

Summary During a nine-year study period, 96 episodes of nosocomial bloodstream infection (BSI) due to Acinetobacter baumannii were identified in the adult intensive care units (ICUs) of Shin Kong Wu Ho-Su Memorial Hospital. Seventy-seven (80.2%) of these were available for matching in terms of age,...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of hospital infection 2009-10, Vol.73 (2), p.143-150
Main Authors: Jang, T.-N, Lee, S.-H, Huang, C.-H, Lee, C.-L, Chen, W.-Y
Format: Article
Language:English
Subjects:
Acinetobacter baumannii
Acinetobacter baumannii - classification
Acinetobacter baumannii - drug effects
Acinetobacter baumannii - isolation & purification
Acinetobacter Infections - epidemiology
Acinetobacter Infections - microbiology
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacteremia - epidemiology
Bacteremia - microbiology
Bloodstream infection
Case-Control Studies
Cross Infection - epidemiology
Cross Infection - microbiology
Disease Outbreaks
Female
Humans
Incidence
Infectious Disease
Intensive care unit
Intensive Care Units
Male
Microbial Sensitivity Tests
Middle Aged
Risk Factors
Taiwan - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary During a nine-year study period, 96 episodes of nosocomial bloodstream infection (BSI) due to Acinetobacter baumannii were identified in the adult intensive care units (ICUs) of Shin Kong Wu Ho-Su Memorial Hospital. Seventy-seven (80.2%) of these were available for matching in terms of age, sex, primary diagnosis of ICU admission, ICU ward, and disease severity. Univariate analysis showed that central venous catheter use, ventilator use, prior A. baumannii colonisation, and respiratory and cardiovascular organ failure were significantly associated with acquiring A. baumannii BSI in the ICU. By multivariate analysis, only prior A. baumannii colonisation [odds ratio (OR): 3.81; P < 0.001] and cardiovascular failure (OR: 2.24; P = 0.04) were identified as independent risk factors. The lower respiratory tract (32/77; 41.6%) was the most frequent source of infection, followed by intravascular catheters (13/77; 16.9%). Cumulative survival curves for patients with A. baumannii BSI and control patients showed no significant difference (30 day crude mortality: 29.9% and 27.3%, respectively; P = 0.916). However, the mean length of ICU and hospital stay and mean hospital cost of patients with A. baumannii BSI significantly increased, with an estimated 8.7 days excess length of ICU stay, 19.1 days excess hospital stay, and US $8480 extra hospital costs. Imipenem and meropenem remained the most active antimicrobial agents, both with 95.5% susceptibility (MIC50 = 0.25 and 0.5, respectively). Improving hand hygiene of healthcare workers and aseptic care of vascular catheters and endotracheal tubes are important measures to prevent A. baumannii colonisation and decrease the incidence of BSI.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2009.06.007