Tuberc Respir Dis.  2006 Feb;60(2):228-234.

Clinical Characteristics of Intensive Care Unit Patients with Carbapenem Resistant Acinetobacter Baumannii Isolated from Sputum

• Lee SW
• Jo HS
• Kim WJ

Abstract

BACKGROUND: Acinetobacter baumannii is an important pathogen associated with nosocomial infections in intensive care units, and is responsible for nosocomial pneumonia, UTI, bacteremia, etc. The main concern is that this pathogen is often resistant to many antimicrobial agents, particularly to carbapenem. This study compared the clinical those of ICU admitted patients with the carbapenem resistant A. baumannii isolated from the sputum with characteristics of patients with carbapenem sensitive A. baumannii.
METHODS
A total of 49 patients with A. baumannii from a sputum culture who were admitted to the ICU from January to December 2003 were enrolled in this study. This study evaluated the demographic variables, mortality, APACHE II score, comorbidity, antibiotics used, hospital and ICU stay, Clinical Pulmonary Infection Score, and mechanical ventilation. A retrospective analysis was made by a review of the patients' medical records.
RESULTS
Carbapenem sensitive and resistant A. baumannii was isolated from 23 patients and 26 patients respectively. Univariate analysis revealed renal disease, the use of carbapenem and aminoglycoside to be statistically significant factors for carbapenem resistance. Multivariate analysis revealed carbapenem use(p=0.024; OR, 8.17; CI 1.32 to 50.68) to be positively associated with carbapenem resistance, and aminoglycoside use(p=0.026; OR, 0.18; CI, 0.04 to 0.82) to be negatively associated with carbapenem resistance. There was no significant difference in mortality between the carbapenem sensitive and resistant group(30 vs 42%. P=0.39).
CONCLUSION
The occurrence of carbapenem resistant A. baumannii is positively associated with carbapenem use and negatively associated with aminoglycoside use. Carbapenem resistance in the sputum culture did not affect the mortality rate.

Keyword

Acinetobacter baumannii; Drug resistance; Carbapenem

MeSH Terms

Acinetobacter baumannii*
Acinetobacter*
Anti-Bacterial Agents
Anti-Infective Agents
APACHE
Bacteremia
Comorbidity
Cross Infection
Drug Resistance
Drug Resistance, Bacterial
Humans
Intensive Care Units*
Critical Care*
Medical Records
Mortality
Multivariate Analysis
Pneumonia
Respiration, Artificial
Retrospective Studies
Sputum*
Anti-Bacterial Agents
Anti-Infective Agents