Nosocomial acquisition of multiresistant Acinetobacter baumannii: risk factors and prognosis.

Authors

Lortholary O, Fagon JY, Hoi AB, et al. 

Institution

Service de Médecine Interne, Université Paris Nord, Bobigny, France.

Source

Clin Infect Dis 1995 Apr; 20(4) :790-6.

Abstract

To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A. baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11-3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001).

Mesh

APACHE
Acinetobacter
Acinetobacter Infections
Aged
Aged, 80 and over
Case-Control Studies
Cross Infection
Drug Resistance, Multiple
Female
Humans
Logistic Models
Male
Microbial Sensitivity Tests
Middle Aged
Prognosis
Prospective Studies
Risk Factors

Language

eng

Pub Type(s)

Journal Article

PubMed ID

7795075