Epidemiology and risk factors for colonization and infection by Acinetobacter baumannii in an ICU in Tunisia, where this pathogen is endemic

Brahmi, Nozha; Beji, Olfa; Abidi, Nour; Kouraichi, Nadia; Blel, Youssef; Ghord, H. El; Thabet, H.; Amamou, M.

doi:10.1007/s10156-007-0557-0

Cited by 22 publications

(17 citation statements)

References 27 publications

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“…The mortality of patients from whom Acb complex strains were isolated was 11.6%, which was lower than those of previous reports (13,14). This could be due to the fact that Acb complex in this study had greater sensitivity to antibiotics.…”

Section: Discussioncontrasting

confidence: 53%

“…In their study, approximately 80% of isolates acquired multidrugresistance. Furthermore, another study showed that MDRAB accounted for 46.3% of A. baumannii infections (14).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is very important to distinguish between colonization and infection and to use the appropriate antibiotics in order to prevent drug resistance. However, there are few reports which discuss the risk factors of A. baumannii infection (13,14). Furthermore, the current condition of A. baumannii infection in Japan must be evaluated in particularly in reference to the recent troubling major outbreak of MDRAB at Teikyo University Hospital in Japan (15).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

et al. 2012

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Objective Acinetobacter baumannii is a worldwide nosocomial pathogen that has become increasingly common over the past few decades, and strains of multidrug-resistant A. baumannii have been increasing. The aim of this study was to assess the clinical characteristics of A. calcoaceticus-A. baumannii complex (Acb complex) strains and to determine the risk factors of this infection. Methods The medical records of 121 patients at Nagasaki University Hospital from whom Acb complex had been isolated between January 2007 and December 2009 were retrospectively reviewed. Patient backgrounds, sensitivity to antibiotics, risk factors for infection, and prognosis were evaluated. Results Lower respiratory isolates accounted for 73% (147 strains) of all 201 isolates. Most of the isolates were sensitive to carbapenems. Of the 121 patients (74 males and 47 females; mean age: 62.1 years), 48 (39.7%) had malignancy and 75 (62.0%) were treated with antibiotics prior to isolation. Thirty-seven of the patients in this study (30.6%) were infected by Acb complex and the most frequent clinical manifestation was pneumonia (18 cases; 48.6%). Approximately 60% of infected patients were treated with β-lactam agent in combination with β-lactamase inhibitors or carbapenems. The mortality rate of infected patients was significantly higher than that of colonized patients (infected: 24.3%, colonized: 6.0%, p<0.05). Risk factors for Acb complex infection include being over 60 years of age, chronic liver disease, and the use of firstgeneration cephalosporins prior to isolation. Conclusion Acb complex was relatively sensitive to antibiotics. The appropriate usage of antibiotics should be continued for the prevention of drug resistance in Acb complex.

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Section: Discussioncontrasting

confidence: 53%

“…In their study, approximately 80% of isolates acquired multidrugresistance. Furthermore, another study showed that MDRAB accounted for 46.3% of A. baumannii infections (14).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

et al. 2012

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“…As rates of infection have increased, so has the incidence of infection with multidrug-resistant (MDR) isolates of Acinetobacter species, defined as those strains that are resistant to three or more classes of antibiotics (9)(10)(11)(12)(13). In fact, many regions of the world now encounter A. baumannii strains that are resistant to the two agents most commonly used to treat A. baumannii: type 2 carbapenems (such as imipenem, meropenem, and doripenem) and ampicillin-sulbactam.…”

mentioning

confidence: 99%

Epidemiology of Bloodstream Infections Caused by Acinetobacter baumannii and Impact of Drug Resistance to both Carbapenems and Ampicillin-Sulbactam on Clinical Outcomes

Chopra

Marchaim

Awali

et al. 2013

Antimicrob Agents Chemother

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In-hospital mortality rates for BSI caused by CASR A. baumannii were significantly higher than those for non-CASR A. baumannii-induced BSI (43% versus 20%; OR ‫؍‬ 3.0, 95% CI ‫؍‬ 1.60 to 5.23, P value < 0.001). However, after adjusting for potential confounders, the association between BSI caused by CASR A. baumannii and increased risk of in-hospital mortality was not significant (OR ‫؍‬ 1.15, 95% CI ‫؍‬ 0.51 to 2.63, P value ‫؍‬ 0.74). This study demonstrated that CASR A. baumannii had a distinct epidemiology compared to more susceptible A. baumannii strains; however, clinical outcomes were similar for the two groups. Admission with a rapidly fatal condition was an independent predictor for both CASR A. baumannii and in-hospital mortality.

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“…MDRAB colonization increases the risk of spread in the hospital setting (1). Many previous studies have investigated risk factors for acquisition of, or infection with MDRAB (2,3). Antibiotic use, dialysis, and prolonged intensive care unit stay have been identified as risk factors for colonization or infection with MDRAB (4)(5)(6)(7)(8).…”

Section: Multidrug-resistantmentioning

confidence: 99%

Co-Colonization with <i>Neisseria species</i> Is a Risk Factor for Prolonged Colonization with Multidrug-Resistant <i>Acinetobacter baumannii</i> in the Respiratory Tract

et al. 2017

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SUMMARY: Multidrug-resistant Acinetobacter baumannii (MDRAB) colonization increases the risk of bacterial spread in the hospital setting. The impact of clinical factors, including antibiotic use, on prolongation of MDRAB colonization has not been investigated. Patients with respiratory tract MDRAB detected using culture were enrolled in this study. Long-term colonizers and short-term colonizers were defined as patients whose colonization periods were ＞30 days or 30 days, respectively. Clinical data were abstracted from medical records. MDRAB was isolated in 34 patients. There were 13 long-term colonizers and 9 short-term colonizers. Twelve patients were lost to follow-up and excluded from the study. There were no significant differences in average leukocyte counts, numbers of antibiotic classes administered, duration of antibiotic use in the 30 days following colonization, or rates of central catheterization or mechanical ventilation between the 2 groups. Long-term colonizers carried Neisseria species (spp.) more frequently in the 30 days following colonization than short-term colonizers (7/13 vs 1/9, p ＝ 0.01); however, this was not the case prior to colonization with MDRAB (5/13 vs 1/9, p ＝ 0.33). The 90-day MDRAB colonization rates for Neisseria-negative patients and Neisseria-positive patients were 10.0z and 83.3z, respectively (P ＜ 0.01). Prolonged MDRAB colonization in the respiratory tract was associated with Neisseria spp. co-colonization. Multidrug-resistantAcinetobacter baumannii (MDRAB) is an important pathogen in hospitalacquired infection. MDRAB colonization increases the risk of spread in the hospital setting (1). Many previous studies have investigated risk factors for acquisition of, or infection with MDRAB (2,3). Antibiotic use, dialysis, and prolonged intensive care unit stay have been identified as risk factors for colonization or infection with MDRAB (4-8). MDRAB has been associated with co-infecting organisms such as Staphylococcus or Pseudomonas species (spp.) (4). However, questions about the colonization period of MDRAB and the association of colonization with clinical or microbiological factors have not been answered. We experienced an MDRAB outbreak in our hospital from 2009 to 2011. The objectives of this study were to investigate the duration of MDRAB colonization in the respiratory tract after the acquisition of MDRAB, and the association between duration of MDRAB colonization and clinical or microbiological factors.All patients with MDRAB on throat or sputum cultures from 25 August 2009 through 17 March 2012 at the Teikyo University Hospital were included. The study site's institutional review board approved the review of the infection control data. Informed consent was waived. The samples were used to inoculate modified CHROMagar Acinetobacter plates (Chromagar, Paris, France), which were then incubated at 379 C and examined after 48 hours for oxidase-negative and bright salmon-red colonies that are indicative of MDRAB. Antimicrobial susceptibilities were analyzed using the curren...

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Epidemiology and risk factors for colonization and infection by Acinetobacter baumannii in an ICU in Tunisia, where this pathogen is endemic

Cited by 22 publications

References 27 publications

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

Epidemiology of Bloodstream Infections Caused by Acinetobacter baumannii and Impact of Drug Resistance to both Carbapenems and Ampicillin-Sulbactam on Clinical Outcomes

Co-Colonization with <i>Neisseria species</i> Is a Risk Factor for Prolonged Colonization with Multidrug-Resistant <i>Acinetobacter baumannii</i> in the Respiratory Tract

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