Risk Factors For Nosocomial Pan Drug Resistant Acinetobacter Baumannii Infections

Yıl 2019, , 254 - 260, 26.10.2019

Havva Tünay , Tuna Demirdal , Neşe Demirtürk

https://doi.org/10.30565/medalanya.543371

Cited By: 2

Öz

Aim: Acinetobacter baumannii is an important nosocomial pathogen. The purpose of this study was to identify risk factors and mortality of nosocomial infections caused by pan drug resistant (PDR) Acinetobacter baumannii and to characterize their effects on mortality.

Patients and Methods: This study was performed at the Afyonkarahisar Helath Science University, Faculty of Medicine. Nosocomial infections were defined accor-ding to the American Center for Disease Control (CDC). Patients with nosocomial infections caused by Acinetobacter baumannii were included in the study. Patients identified as PDR Acinetobacter baumannii and non-PDR Acinetobacter baumannii infection were com-pared in terms of risk factors.

Results: Two different groups were constructed, one group consisting of 145 PDR and the other of 145 non-PDR Acinetobacter baumannii cases. Stay history in an internal intensive care unit (p=0.001), their duration of hospital stay (p=0.031), renal disease (p=0.003), mechanical ventilation (p=0.001), prior usage history of carbap-enem (p=0.001), presence of nosocomial pneumonia (p=0.001), were independent risk factors associated with PDR Acinetobacter baumannii infections. The mortality rate for the PDR group was 61.8% and it was 38.2% in the non-PDR group (p=0.008).

Conclusion: PDR Acinetobacter baumannii infections are important nosocomial in-fections with a high mortality rate. Patients’ carbapenem usage, stay history in an internal intensive care unit, renal comorbid diseases, and a diagnosis of nosocomial pneumonia are important risk factors for PDR Acinetobacter baumannii infections. In nosocomial infections caused by PDR Acinetobacter baumannii, many risk factors were modifiable. 

Anahtar Kelimeler

Acinetobacter baumannii, antibiotic resistance, antimicrobial therapy

Hastane Kaynaklı Pan Drug Resistant Acinetobacter Baumannii Enfeksiyonlarında Risk Faktörleri

Öz

Amaç: Acinetobacter baumannii, önemli nozokomiyal bir patojendir. Bu çalışmanın amacı, pan drug resistant (PDR) Acinetobacter baumannii nedenli nosokomiyal enfeksiyonlar için risk faktörlerinin ve mortalite üzerine olan etkinin tanımlanmasıdır. 

Hastalar ve Yöntemler: Çalışma Afyon Kocatepe Üniversitesi Tıp Fakültesi’nde gerçekleştirilmiştir. Amerikan Hastalık Kontrol Merkezi (CDC) tanı kriterlerine göre tanımlanmıştır. Acinetobacter baumannii nedenli nozokomiyal enfeksiyon tanımlanan hastalar çalışmaya dahil edilmiştir. PDR Acinetobacter baumannii ve non-PDR Acinetobacter baumannii enfeksiyonu saptanan olgular risk faktörleri yönünden karşılaştırılmıştır 

Bulgular: Biri 145 PDR diğeri 145 PDR olmayan Acinetobacter baumannii vakalarından oluşan iki farklı grup oluşturuldu. Dahili yoğun bakım ünitesinde yatış öyküsü (p=0,001), hastanede kalış süresi PDR grupta ortalama 28,2±23,0 (p=0,031), renal hastalık (p=0,003), mekanik ventilasyon (p=0,001),önceden karbapenem kullanma öyküsü (p=0,001), nozokomiyal pnömoni varlığı, (p=0,001 bağımsız risk faktörü olmuştur. Mortalite oranı PDR grupta % 61,8, non-PDR grupta % 38,2, olarak belirlenmiştir (p=0,008). 

Sonuç: PDR Acinetobacter baumannii enfeksiyonları mortalite oranı yüksek önemli nozokomiyal infeksiyonlardır. Dahili yoğun bakım ünitesinde yatış öyküsü, hastanede kalış süresi, renal hastalık, mekanik ventilasyon, karbapenem kulanım öyküsü, nozokomiyal pnömoni varlığı, solunum sekresyon örneği PDR Acinetobacter baumannii enfeksiyonu için önemli risk faktörleridir. PDR Acinetobacter baumannii nedenli nozokomiyal enfeksiyonlarda çoğu risk faktörleri düzeltilebilir özelliktedir. 

Anahtar Kelimeler

Acinetobacter baumannii, antibiyotik direnci, antimikrobiyal tedavi

Kaynakça

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