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Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit

BACKGROUND: Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further coloniz...

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Autores principales: Jung, Ji Ye, Park, Moo Suk, Kim, Song Ee, Park, Byung Hoon, Son, Ji Young, Kim, Eun Young, Lim, Joo Eun, Lee, Sang Kook, Lee, Sang Hoon, Lee, Kyung Jong, Kang, Young Ae, Kim, Se Kyu, Chang, Joon, Kim, Young Sam
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921386/
https://www.ncbi.nlm.nih.gov/pubmed/20670453
http://dx.doi.org/10.1186/1471-2334-10-228
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author Jung, Ji Ye
Park, Moo Suk
Kim, Song Ee
Park, Byung Hoon
Son, Ji Young
Kim, Eun Young
Lim, Joo Eun
Lee, Sang Kook
Lee, Sang Hoon
Lee, Kyung Jong
Kang, Young Ae
Kim, Se Kyu
Chang, Joon
Kim, Young Sam
author_facet Jung, Ji Ye
Park, Moo Suk
Kim, Song Ee
Park, Byung Hoon
Son, Ji Young
Kim, Eun Young
Lim, Joo Eun
Lee, Sang Kook
Lee, Sang Hoon
Lee, Kyung Jong
Kang, Young Ae
Kim, Se Kyu
Chang, Joon
Kim, Young Sam
author_sort Jung, Ji Ye
collection PubMed
description BACKGROUND: Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU. METHODS: We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009. RESULTS: Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; P = 0.035, 22.9 vs. 16.8; P < 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; P = 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; P = 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; P = 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia. CONCLUSIONS: Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia.
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spelling pubmed-29213862010-08-14 Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit Jung, Ji Ye Park, Moo Suk Kim, Song Ee Park, Byung Hoon Son, Ji Young Kim, Eun Young Lim, Joo Eun Lee, Sang Kook Lee, Sang Hoon Lee, Kyung Jong Kang, Young Ae Kim, Se Kyu Chang, Joon Kim, Young Sam BMC Infect Dis Research Article BACKGROUND: Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU. METHODS: We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009. RESULTS: Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; P = 0.035, 22.9 vs. 16.8; P < 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; P = 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; P = 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; P = 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia. CONCLUSIONS: Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia. BioMed Central 2010-07-30 /pmc/articles/PMC2921386/ /pubmed/20670453 http://dx.doi.org/10.1186/1471-2334-10-228 Text en Copyright ©2010 Jung et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Jung, Ji Ye
Park, Moo Suk
Kim, Song Ee
Park, Byung Hoon
Son, Ji Young
Kim, Eun Young
Lim, Joo Eun
Lee, Sang Kook
Lee, Sang Hoon
Lee, Kyung Jong
Kang, Young Ae
Kim, Se Kyu
Chang, Joon
Kim, Young Sam
Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title_full Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title_fullStr Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title_full_unstemmed Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title_short Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
title_sort risk factors for multi-drug resistant acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921386/
https://www.ncbi.nlm.nih.gov/pubmed/20670453
http://dx.doi.org/10.1186/1471-2334-10-228
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