A RISING THREAT – RISK FACTORS AND OUTCOMES RELATED TO INFECTIONS WITH ACINETOBACTER SPECIES
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i3.15364Abstract
ABSTRACT
Objective: Acinetobacter species is an important cause of community as well as nosocomial infections with a high mortality rate. The study was done
to analyze the risk factors associated with Acinetobacter infections and their outcomes.
Methods: The clinical details of 100 patients having infections with Acinetobacter species over a period of 1-year were analyzed for underlying risk
factors and outcomes. The antibiotic sensitivity results were interpreted according to the Clinical Laboratory Standards Institute guidelines.
Results: Majority of the infections caused by the Acinetobacter species were lower respiratory tract infections, most common being ventilatorassociated
pneumonia. 47% of the isolates were multi drug resistant and 26% were extensively drug resistant. There is a significant chance of drug
resistance and a poor outcome with intensive care unit (ICU) stay, prolonged hospital stay of more than 7 days, the presence of 5 or more risk factors.
Endotracheal intubation and mechanical ventilation were the risk factors for increased drug resistance in the ICU. Drug resistance was also seen more
frequently in patients with chronic obstructive pulmonary disease, chronic kidney disease, and patients on post-operative care.
Conclusion: The steady increase in drug resistant Acinetobacter species and limited antibiotics available advocates an uncompromising approach
toward infection control and a judicious use of antibiotics especially in the ICU. An understanding about the risk factors helps in the appropriate
approach and management of the patient.
Keywords: Acinetobacter, Risk factors, Invasive procedures, Nosocomial.
Downloads
References
REFERENCES
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: Emergence of a successful pathogen. Clin Microbiol Rev 2008;21(3):538-82.
Sinha N, Agarwal J, Srivastava S, Singh M. Analysis of carbapenem-resistant Acinetobacter from a tertiary care setting in North India. Indian J Med Microbiol 2013;31(1):60-3.
Singla P, Sikka R, Deep A, Seema, Chaudhary U. Pattern of antimicrobial resistance in clinical isolates of Acinetobacter species at a tertiary level health care facility in Northern India. J Evol Med Dent Sci 2013;2(2):159-65.
GarcÃa-Garmendia JL, Ortiz-Leyba C, Garnacho-Montero J, Jiménez-Jiménez FJ, Pérez-Paredes C, Barrero-Almodóvar AE, et al. Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients: A cohort study. Clin Infect Dis 2001;33(7):939-46.
Prashanth K, Badrinath S. Nosocomial infections due to Acinetobacter species: Clinical findings, risk and prognostic factors. Indian J Med Microbiol 2006;24(1):39-44.
Lone R, Shah A, Kadri SM, Lone S, Faisal S. Nosocomial multi-drug-resistant Acinetobacter infections-clinical findings, risk factors and demographic characteristics. Bangladesh J Med Microbiol 2009;3(1):34-8.
Cardoso T, Ribeiro O, Aragão IC, Costa-Pereira A, Sarmento AE. Additional risk factors for infection by multidrug-resistant pathogens in healthcare-associated infection: A large cohort study. BMC Infect Dis 2012;12:375.
American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171(4):388-416.
Asian J Pharm Clin Res, Vol 10, Issue 3, 2017, 108-111
Khurana et al.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third International Supplement. M100-S23. Wayne, PA: CLSI; 2013.
Choi JY, Kim CO, Park YS, Yoon HJ, Shin SY, Kim YK, et al. Comparison of efficacy of cefoperazone/sulbactam and imipenem/cilastatin for treatment of Acinetobacter bacteremia. Yonsei Med J 2006;47(1):63-9.
Principe L, D’Arezzo S, Capone A, Petrosillo N, Visca P. In vitro activity of tigecycline in combination with various antimicrobials against multidrug resistant Acinetobacter baumannii. Ann Clin Microbiol Antimicrob 2009;8:18.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18(3):268-81.
Vaze ND, Emery CL, Hamilton RJ, Brooks AD, Joshi SG. Patient demographics and characteristics of infection with carbapenem-resistant Acinetobacter baumannii in a teaching hospital from the United States. Adv Infect Dis 2013;3(1):10-6.
Lee SO, Kim NJ, Choi SH, Hyong Kim T, Chung JW, Woo JH, et al. Risk factors for acquisition of imipenem-resistant Acinetobacter baumannii: A case-control study. Antimicrob Agents Chemother 2004;48(1):224-8.
Tilley PA, Roberts FJ. Bacteremia with Acinetobacter species: Risk factors and prognosis in different clinical settings. Clin Infect Dis 1994;18(6):896-900.
Tripathi PC, Gajbhiye SR, Agrawal GN. Clinical and antimicrobial profile of Acinetobacter spp: An emerging nosocomial superbug. Adv Biomed Res 2014;3:13.
Cisneros JM, RodrÃguez-Baño J. Nosocomial bacteremia due to Acinetobacter baumannii: Epidemiology, clinical features and treatment. Clin Microbiol Infect 2002;8(11):687-93.
Howard A, O’Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: An emerging opportunistic pathogen. Virulence 2012;3(3):243-50.
Corbella X, Pujol M, Ayats J, Sendra M, Ardanuy C, DomÃnguez MA, et al. Relevance of digestive tract colonization in the epidemiology of nosocomial infections due to multi resistant Acinetobacter baumannii. Clin Infect Dis 1996;23(2):329-34.
Timsit JF, Garrait V, Misset B, Goldstein FW, Renaud B, Carlet J. The digestive tract is a major site for Acinetobacter baumannii colonization in intensive care unit patients. J Infect Dis 1993;168(5):1336-7.
Falagas ME, Bliziotis IA, Siempos II. Attributable mortality of Acinetobacter baumannii infections in critically ill patients: A systematic review of matched cohort and case-control studies. Crit Care 2006;10(2):R48.
Fukuta Y, Muder RR, Agha ME, Clarke LG, Wagener MM, Hensler AM, et al. Risk factors for acquisition of multidrug-resistant Acinetobacter baumannii among cancer patients. Am J Infect Control 2013;41(12):1249-52.
Surasarang K, Narksawat K, Danchaivijitr S, Siripanichgon K, Sujirarat D, Rongrungrueng Y, et al. Risk factors for multi-drug resistant Acinetobacter baumannii nosocomial infection. J Med Assoc Thai 2007;90(8):1633-9.
Anunnatsiri S, Tonsawan P. Risk factors and clinical outcomes of multidrug-resistant Acinetobacter baumannii bacteremia at a university hospital in Thailand. Southeast Asian J Trop Med Public Health 2011;42(3):693-703.
Liu WL, Liang HW, Lee MF, Lin HL, Lin YH, Chen CC, et al. The impact of inadequate terminal disinfection on an outbreak of imipenem-resistant Acinetobacter baumannii in an intensive care unit. PLoS One 2014;9(9):e107975.
Pooja BM, Sweta RS, Sheela DK, Dileep VK. Characterization of carbapenem resistant Acinetobacter baumannii isolated in a tertiary care hospital: Epidemiology and treatment outcome. Int J Pharm Pharm Sci 2016;8(7):277-81.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
