Intensive care unit A. baumannii infection, risk factors and antibiotic resistance cases

Objective: Acinetobacters have a significant place within pathogens causing infections arising from intensive care. Our objective in this study is to evaluate demographic data, clinical characteristics and antibiotic resistance conditions by years belonging to patients whom A. baumannii grew in respiratory intensive care cultures.Material and method:The patients who have hospitalized between August 2006 and June 2010 in Intensive Care Unit of Pulmonary Diseases Clinic of Dicle University Medical Faculty having Acinetobacter baumannii reproduction in their sample culture outcomes are included in the study. Age, sex, antibiotic treatments initiated within the first 48 hours, smoking stories, accompanying comorbidities, systemic steroid administration story, dopamine infusion requirement, culture antibiogram results, NIMV and IMV applications and application periods, duration of hospitalization, scores and outcomes (live, deceased) of APACHE II and SOFA has been evaluated in order to determine the risk factors of A. baumannii infection.Findings: 70 cases in total have been evaluated. 45 of the patients (64.3 %) were female, while 25 of them were (35.7 %) male. The average was 62.36 ± 16.8 years, smoking amount was 57.27 ± 33.3 packs / year, systemic steroid administration was 45.7 %, the rate of receiving antibiotics treatment within the first 48 hours was 97.1 %, dopamine infusion requirement was 85.7 %, and rate of additional diseases was 94.3 % among then patients. The actual mortality rate was 87.1 %. NIMV is required for 43 patients, while IMV is required for 66 patients. APACHE II score was 24.69 ± 8.37 and SOFA score was 10.43 ± 3.42. The samples were found to be isolated in blood (47 %), tracheal aspirate (31 %), urine (8.3 %), wound site (8.3 %), catheter (4.8 %). 41.4 of the patients (29 patients) had been started ceftriaxone within the first 48 hours. An increasing resistance over year has been detected in carbapenems and cephaperazon/sulbactamads. There was no cholistin resistance. There were a significant relation between smoking amount (p=0.05) and duration of hospitalization (p=0.03).Conclusion: The carbapenem type antibiotics resistance of A. baumannii in our intensive care unit was a significant problem and long durations of hospitalization and smoking amount was related to mortality.Keywords: A. baumannii, antibiotics resistance, intensive care unit