MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII INFECTION IN RESPIRATORY INTENSIVE CARE UNIT
Makaleler > Tam Makale · 2009
Yazarlar: FEZA BACAKOĞLU, Pervin KORKMAZ, Mehmet Sezai TAŞBAKAN, Burcu Başarık, Huesnue Pullukcu, Soehret AYDEMIR, Alev GÜRGÜN, Oezen Kacmaz Basoglu
MIKROBIYOLOJI BULTENI, SCI Expanded İndekslerine Giren Dergi, Uluslararası, 2009, cilt 43, ss 575-585
DOI: 10.3760/cma.j.issn.0376-2491.2012.14.008
Özet
Multidrug-resistant Acinetobacter baumannii is a challenge in the treatment and control of nosocomial infections. This retrospective study was aimed to investigate the prevalence of multidrug resistant A.baumannii in a respiratory intensive care unit (ICU), related risk factors and its impact on disease prognosis. Of 218 patients who were hospitalized in our ICU during the last two years; 37 (17%) patients (21 males, mean age 61.6 +/- 19.8 years) developed pneumonia and/or bacteremia due to multidrug-resistant A.baumannii. Previous antibiotic therapy was detected in 51.4% and hospitalization in 70.3% of the cases. Pneumonia (59.5%) was the most frequent cause of hospitalization and chronic obstructive pulmonary disease (21.6%) was the second one; 81.1% of patients had co-morbidity. Invasive mechanical ventilation was performed in 31 (83.7%) patients during the follow-up. Ventilator-associated pneumonia developed in 22 (59.5%) patients and bacteraemia in 9 (24.3%) patients. Multidrug-resistance was observed in 23 (62.2%) of patients. Highest rates of resistance (100%) was detected against piperacillin-tazobactam, ampicillin-sulbactam and ciprofloxacin, followed by imipenem and cefepime (78%), meropenem and ceftazidime (55%), cefoperazone-sulbactam (43%) and netilmicin (35.1). The rates of re-intubation and tracheotomy were higher in patients infected with A.baumannii compared to the control group (59.5% vs. 7.7%, p < 0.0001 and 21.6% vs. 3.9%, p = 0.001, respectively). There was no significant difference between two groups in terms of mortality, however, durations of ICU and hospital stays were longer in patients with multidrug-resistant A.baumannii infection than without infection (24.2 +/- 18.3 vs. 8.2 +/- 8.3 days, p < 0.001 and 33.3 +/- 19.8 vs. 15.4 +/- 11.4 days, p < 0.001, respectively). In conclusion, due to the high rates of drug-resistance in nosocomial A.baumannii isolates, the use of invasive procedures and durations of ICU and hospital stays exhibit an increasing trend.