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Am J Infect Control. 2010 Oct;38(8):631-5. doi: 10.1016/j.ajic.2010.01.009. Epub 2010 May 14.

Predictors of mortality of Acinetobacter baumannii infections: A 2-year prospective study in a Greek surgical intensive care unit.

Author information

1
Surgical Intensive Care Unit, First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece.

Abstract

BACKGROUND:

Nosocomial infections are a frequent and continuously increasing problem worldwide, have a rapidly increasing multidrug resistance to antibiotics, and are associated with significant morbidity and mortality.

OBJECTIVE:

Our objectives were to evaluate Acinetobacter baumannii infection incidence in our surgical intensive care unit (SICU), the clinical features and outcome of these patients, and, particularly, to investigate predictors of A baumannii infection-related mortality.

METHODS:

Ours was a prospective study of all patients with ICU-acquired A baumannii infection from January 1, 2006, to December 31, 2007.

RESULTS:

Among 680 patients, 60 (8.8%) sustained A baumannii infection. Mean age was 68.4 ± 6.2 years, Acute Physiology and Chronic Health Evaluation (APACHE) II score on SICU admission 20.6 ± 8.1 and Sequential Organ Failure Assessment (SOFA) score on infection day 9.5 ± 4.2 (women: 50%). Multidrug resistance, morbidity, and mortality were 45%, 65%, and 46.6% (n = 28), respectively. In multivariate analysis, age (P = .03; odds ratio [OR], 1.13; 95% confidence interval [CI]: 1.018-1.259), acute renal failure (P = .001; OR, 17.9; 95% CI: 6.628-75.565), and thrombocytopenia (P = .03; OR, 26.4; 95% CI: 1.234-56.926) complicating the infection and subsequent Enterococcus faecium bacteremia (P = .01; OR, 3.5; 95% CI: 1.84-6.95) were mortality predictors.

CONCLUSION:

A baumannii infections are frequent and associated with high drug multiresistance, morbidity, and mortality. Age, renal failure, thrombocytopenia, and subsequent E faecium bacteremia were predictors of A baumannii infection-associated mortality.

PMID:
20471716
DOI:
10.1016/j.ajic.2010.01.009
[Indexed for MEDLINE]

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