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

A multi-center study on the risk factors of infection caused by multi-drug resistant Acinetobacter baumannii.
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Huang H, Chen B, Liu G, Ran J, Lian X, Huang X, Wang N, Huang Z,


Huang H, Chen B, Liu G, Ran J, Lian X, Huang X, Wang N, Huang Z, (click to view)

Huang H, Chen B, Liu G, Ran J, Lian X, Huang X, Wang N, Huang Z,

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BMC infectious diseases 2018 01 0518(1) 11 doi 10.1186/s12879-017-2932-5
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.

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