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BMC Infect Dis. 2018 Jan 5;18(1):11. doi: 10.1186/s12879-017-2932-5.

A multi-center study on the risk factors of infection caused by multi-drug resistant Acinetobacter baumannii.

Author information

1
Department of Infection Control, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361003, China.
2
Department of Gastrointestinal Surgery, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, Fujian, 361003, China.
3
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361003, China.
4
Department of Infection Control, The Second Hospital of Xiamen, Xiamen, Fujian, 361021, China.
5
Department of Infection Control, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, 361003, China.
6
Department of Gastrointestinal Surgery, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, Fujian, 361003, China. huangzhengjie@xmu.edu.cn.

Abstract

BACKGROUND:

Acinetobacter baumannii (AB) is critical for healthcare-associated infections (HAI) with significant regional differences in the resistance rate, but its risk factors and infection trends has not been well studied. We aimed to explore the risk factors, epidemiological characteristics and resistance of multidrug-resistant Acinetobacter baumannii (MDR-AB) in intensive care unit inpatients.

METHODS:

Data of patients with MDR-AB (195 cases), and with antibiotic-sensitive AB infection (294 cases, control) during January to December, 2015 in three medical centers in Xiamen, China were conducted and analyzed in the present retrospective study.

RESULTS:

Lower respiratory tract infection with AB accounted for 68.71%. MDR-AB was detected in 39.88% of all cases. Univariate analysis suggested that mechanical ventilation, indwelling catheter, cancer patients, length of hospitalization in intensive care unit (ICU) ≥15 d, Acute Physiology and Chronic Health Evaluation (APACHE) II score, combined using antibiotic before isolation of AB and use of third-lines cephalosporins were associated with the development of MDR-AB healthcare-associated infections. Dose-response relationship analysis suggested that the age and the days of mechanical ventilation were associated with increased infection with MDR-AB. Logistic regression analysis suggested that, mechanical ventilation, combined using antibiotic before isolation of AB, and indwelling catheter, were associated with MDR-AB infection, with odds ratios (OR) and 95% confidence intervals (CI) of 3.93 (1.52-10.14), 4.11 (1.58-10.73), and 4.15 (1.32-12.99), respectively.

CONCLUSIONS:

MDR-AB infection was associated with mechanical ventilation, combined using antibiotic before isolation of AB, and indwelling catheter. Furthermore, the age and the days of mechanical ventilation were associated with increased infection with MDR-AB.

KEYWORDS:

Acinetobacter baummanii; Intensive care unit; Multi-drug resistant; Risk factors

PMID:
29304746
PMCID:
PMC5756379
DOI:
10.1186/s12879-017-2932-5
[Indexed for MEDLINE]
Free PMC Article

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