Risk factors for nosocomial pan drug resistant Acinetobacter baumannii infections

Aim: A .baumannii is an important nosocomial pathogen. Acinetobacter infections causes long in hospital stay, morbidity and mortality. The aim of this study was to determine the risk factors and effect on mortality for nosocomial infections of PDR A .baumannii.Methods: A study (retrospective case-control)) was performed at Afyon KocatepeUniversity Medical School, from 1st July 2005 to 1st March 2012. Nosocomialinfections were defined according to Center for Disease Control (CDC) criteria.The patients with nosocomial A .baumannii infection were included in the study. First isolation of A .baumannii was considered. Patients with PDR A .baumanniinosocomial infections were compared to those with non-PDR A .baumannii nosocomial infections.Results: Medical intensive care unit stay (odds ratio[OR]:2,74, 95% confidence interval [CI]: 1,53?4,89, p=0,001), duration hospital stay in PDR group 28,2±23,0 (p=0,031), renal disease (OR:3,08 CI:1,43?6,64 p=0,003), mechanical ventilation (OR:7,25 CI:3,12?16,85 p=0,001), previous use of carbapenem (OR:2,22 CI:1,37?3,61 p=0,001), diagnosis of nosocomial pneumonia (OR:2,84 CI:1,76?4,57 p=0,001), samples of respiratory secretion ( OR:2,84, CI:1,76?4,57, p;0,001) were independently associated with PDR Acinetobacter infections. Mortality rate in PDR A. baumannii group was 61,8 %, and 38,2 % in non-PDR A. baumannii group.Conclusion: Medical intensive care unit stay, duration hospital stay, renal disease, mechanical ventilation, previous use of carbapenem, diagnosis of nosocomial pneumonia, samples of respiratory secretion were independently associated with PDR Acinetobacter infections. All risk factors for PDR Acinetobacter infections were modifiable. PDR Acinetobacter infections was associated with mortality.