Adult intensive care UNIT-ACGUİRED nosocomial multi-drug resistant acinetobacter infections: Epidemiology, risk factors and genotyping analysis

We aimed in this study to identify risk factors which thought to be influential in the development of nosocomial multi-drug-resistant Acinetobacter especially A. baumanni infection in adult intensive care units and make comments and suggestions in order to reduce Acinetobacter infections rates and development of treatment protocols with evaluation of antimicrobial susceptibility and genotyping of isolates.This research is being a prospective case-control study tried to determine risk factors which are thought to play a role in the development of infection compared with nosocomial Acinetobacter infection attack was determined with 108 cases and 105 patients whose are control group with any infection are being followed during the same periods between April 2011-March 2012 in adult intensive care units of Inonu University Faculty of Medicine Turgut Ozal Medical Center. The risk factors affecting mortality and nosocomial Acinetobacter infection attack are identified with analysis of univariate and multivariate regression.Age, application of mechanical ventilation, tracheotomy and percutan enterogastrostomi (PEG) and a history of using carbapenem and non-using cephalosporin was found to be an independent risk factor for growth of Acinetobacter on culture after multivariate regression analysis in final model. Enteral feeding and APACHE II score were found independent risk factors affecting mortality in the multivariate logistic regression analysis for mortality in final model. Control of these risk factors and restriction of implementation of broad-spectrum antibiotics such as carbapenems especially in patients who do not need can reduce the rate of nosocomial infections due to Acinetobacter spp.Multiple antibiotic resistance was determined in 94% of the isolates. It`s observed that the imipenem resistance was 82.4% and meropenem resistance was 88%. All isolates were susceptible to colistin. Tigecycline susceptibility was determined as %99,1.In our study observed that the clone which have a many number of isolates continued existence of the hospital was approximately 14 months. This data suggest that multi-drug resistant Acinetobacter clone can remain for many years in the hospital environment and can transmitted from patient-to-patinet if precautions are not taken.