Risk factors and outcomes associated with multidrug-resistant acinetobacter baumannii upon intensive care unit admission
JournalAntimicrobial Agents and Chemotherapy
PublisherAmerican Society for Microbiology
MetadataShow full item record
AbstractMultidrug-resistant (MDR) Acinetobacter baumannii, associated with broadspectrum antibiotic use, is an important nosocomial pathogen associated with morbidity and mortality. This study aimed to investigate the prevalence of MDR A. baumannii perirectal colonization among adult patients upon admission to the intensive care unit (ICU) over a 5-year period and to identify risk factors and outcomes associated with colonization. A retrospective cohort analysis of patients admitted to the medical intensive care unit (MICU) and surgical intensive care unit (SICU) at the University of Maryland Medical Center from May 2005 to September 2009 was performed using perirectal surveillance cultures on admission. Poisson and logistic models were performed to identify associated risk factors and outcomes. Four percent of the cohort were positive for MDR A. baumannii at ICU admission. Among patients admitted to the MICU, those positive for MDR A. baumannii at admission were more likely to be older, to have received antibiotics before ICU admission, and to have shorter length of stay in the hospital prior to ICU admission. Among patients admitted to the SICU, those colonized were more likely to have at least one previous admission to our hospital. Patients positive for MDR A. baumannii at ICU admission were 15.2 times more likely to develop a subsequent positive clinical culture for A. baumannii and 1.4 times more likely to die during the current hospitalization. Risk factors associated with MDR A. baumannii colonization differ by ICU type. Colonization acts as a marker of disease severity and of risk of developing a subsequent Acinetobacter infection and of dying during hospitalization. Therefore, active surveillance could guide empirical antibiotic selection and inform infection control practices. Copyright Copyright 2017 American Society for Microbiology. All Rights Reserved.
SponsorsSupported by National Institutes of Health (NIH) Career Development grants 1K23AI08250 and 5K24AI079040, Centers for Disease Control and Prevention (CDC) Prevention Epicenters Program (grant 1U54CK000450), the National Institute of Allergy and Infectious Diseases (NIAID) of NIH R01AI072219, R21AI114508, R01AI063517, and R01AI100560, Cleveland Department of Veterans Affairs, award 1I01BX001974 from VA Office of Research and Development, the Geriatric Research Education and Clinical Center VISN 10 and the Centers for Disease Control and Prevention (CDC) Prevention Epicenters Program (grant 1U54CK000447).
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85039779989&doi=10.1128%2fAAC.01631-17&partnerID=40&md5=48ad20328d7159a4ea14e2c7f7c1ae4f; http://hdl.handle.net/10713/9448