Carbapenem-resistant Acinetobacter baumannii in intensive care unit patients: risk factors for acquisition, infection and their consequences

• Published in: The Journal of hospital infection Vol. 65; no. 3; pp. 204 - 211
• Main Authors: Playford, E.G, Craig, J.C, Iredell, J.R
• Format: Journal Article
• Language: English
• Published: Kent Elsevier Ltd 01.03.2007; Elsevier
• Subjects: Acinetobacter; Acinetobacter baumannii; Acinetobacter baumannii - drug effects; Acinetobacter baumannii - pathogenicity; Acinetobacter infections; Acinetobacter Infections - drug therapy; Acinetobacter Infections - epidemiology; Acinetobacter Infections - etiology; Adult; Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Australia - epidemiology; Biological and medical sciences; Carbapenems - pharmacology; Case-Control Studies; Case–control study; Cross infection; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Resistance, Bacterial - drug effects; Female; Hospitals, University; Humans; Infection Control; Infectious Disease; Infectious diseases; Intensive care unit; Intensive Care Units; Length of Stay; Male; Medical sciences; Middle Aged; Mortality; Pharmacology. Drug treatments; Retrospective Studies; Risk Factors; Australia; Mortality; Acinetobacter; Cross infection; Acinetobacter infections; Case–control study; Intensive care unit; Length of stay; Human; Prognosis; β-Lactams; Neisseriaceae; Case-control study; Case control study; Infection; Acinetobacter baumannii; Carbapenem derivatives; Risk factor; Bacteria; Micrococcales; Antibacterial agent
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2006.11.010

Summary A retrospective case–control study was performed to assess risk factors and the clinical and economic consequences associated with acquisition of carbapenem-resistant Acinetobacter baumannii (CR-AB) in an intensive care unit (ICU) over a 24-month period. CR-AB was acquired by 64 of 1431 ICU admissions; each was matched with two controls. Risk factors associated with CR-AB acquisition included ICU-wide variables, such as ‘colonization pressure’ (the prevalence of ICU colonized patients) and ICU antibiotic use over the preceding three months, as well as patient-related variables. Among colonized patients, risk factors for CR-AB infection included transfusion and ‘colonization density’ (the proportion of body sites colonized with CR-AB). CR-AB infection was independently associated with increased hospital mortality [mortality difference: 20%; 95% confidence interval (CI): 1–40%], prolonged ICU stay (median length of stay difference: 15 days; 95% CI: 9–21 days) and prolonged hospital stay (30 days, 11–38 days) compared with matched controls.