The epidemiology, risk factors, and their effects on mortality of carbapenem resistant acinetobacter SPP. and pseudomonas spp. infections in intensive care units

Objective: The purpose of the study was to reveal the epidemiology, risk factors ,and their effects on mortality of carbapenem-resistant Acinetobacter spp. and Pseudomonas spp. infections in intensive care units. Method: 46 patients with carbapenem-resistant Acinetobacter spp. and Pseudomonas spp. growth in culture samples taken by active, prospective surveillance from patients hospitalized in the adult intensive care unit (ICU) at Private OFM Antalya Hospital between the dates 01.07.2018-30.06.2019 were included as the case group. 70 patients without the growth of carbapenem-resistant Acinetobacter spp. or Pseudomonas spp. were included in the control group. The demographic information of the patients, admission diagnosis, infection types, risk factors, APACHE II scores, and their additional diseases were obtained from the hospital records. Results: 116 patients who met the criteria under treatment in the ICU of the Private OFM Antalya Hospital were included in the study. There was no significant difference in gender and age between the case-control group (p=0.69 and p=0.35, respectively). There was no significant difference between the case and control groups in terms of risk factors. When healthcare-related infections detected in patients were compared, healthcare-associated pneumonia; 69.56% in the case group and 61.42% in the control group, and there was no statistically significant difference between them. It was found that catheter-related urinary tract infection was higher in the control group (17.14%) compared to the case group (p=0.0075). Central catheter-related bloodstream infection was detected in 26.08% in the case group and 21.42% in the control group, and no statistically significant difference was found between them (p = 0.5637). While the carbapenem-resistant Acinetobacter spp. were the most growth (74%) in case group, in control group the most detected microorganism were Enterobacteriaceae (62.5%). In both groups, the majority of growth was observed in deep tracheal aspirate (DTA). In the study, it was determined that the majority of patients (83.8%) with high APACHE II score (25 and above) died (p=0.0001). Conclusion: More studies are needed to analyze the risk factors of carbapenem-resistant Acinetobacter spp. and Pseudomonas spp. infections in ICUs and their effect on mortality with more number of patients. Each hospital should monitorized the resistance profile changes, update empirical treatment procedures, take necessary isolation precautions, and occupational training should be given regularly.