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

Abstract

BackgroundAcinetobacter 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.MethodsData 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.ResultsLower 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.ConclusionsMDR-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.

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

“…Additionally, resistant bacteria can easily enter the bloodstream through the damaged blood gas barrier, causing blood sepsis [30]. Besides, it is often the case that the maintenance and care of the ventilator tube is not standardized, or the equipment is not properly disinfected, which provides a shortcut for the invasion of the drug-resistant bacteria, which is one of the important reasons for the MDRI in ICU [31,32]. In clinical setting, special attention should be paid to the patient in comatose state and with mechanical ventilation length > 5 days.…”

Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study

“…Nosocomial infections with MDR organisms are major global health issues [1][2][3]. They are very difficult for treatment and main causes of poor clinical outcome, morbidity, mortality, prolonged hospitalization and high health care costs [11,12]. The situation is true and urgent in Ethiopia.…”

Proposing a New Strategy of Combining Machine Learning With Controlling The Cross-Transmission of Multidrug-Resistant Organisms in The ICU

“…In this study, we did not nd signi cant differences between hospital expenses and length of ICU stay. The reason is that we analyzed the difference in age and sex between the two groups only since there were many factors associated with MDRO status, such as mechanical ventilation, chronic renal disease, indwelling catheter, previous hospital stay ≥7 days, high APACHE-II score, and so on (15)(16)(17)(18). A multicentre cohort study developed a prediction model with a good discrimination (AUC-ROC, 0.77; 95%CI, 0.72-0.82), but the sensitivity was 67% and speci city 76.5%, which could not be used to accurately identify patients (18).…”