Acinetobacter baumannii in ICU patients: A prospective study highlighting their incidence, antibiotic sensitivity pattern and impact on ICU stay and mortality

Authors:
  • ASAshraf E. Sileem
    Ashraf E. Sileem
  • ASAhmed Mohamed Said
    Ahmed Mohamed Said
  • MMMahmoud S. Meleha
    Mahmoud S. Meleha
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Abstract
Background: Acinetobacter baumannii (A. baumannii) was considered as a leading cause of nosocomial respiratory infection and bacteremia in many hospitals all over the world. However, there was still a debates whether colonization and/ or infection with A. baumannii, increase morbidity and mortality independently of the effect of other risk factors. Aim of the study: 1. To detect the incidence & mortality rate of the acinetobacter among ICU patient. 2. To compare between colonization and infection by A. baumannii in mortality and outcome. 3. To find the rate of nosocomial respiratory infections from acinetobacter baumannii. Patients and methods: A prospective study was carried out at Al-Adwani General Hospital in Al Taif region, KSA in the ICU department from April 2014 to March 2015. In this study (1280) patients were enrolled after informed consent. only 40 case positive culture of A. baumannii were evaluated. We classified the positive cases into 2 groups. Group (1): Patients who developed nosocomial infection (18 patients). Group (2): Patients who developed colonization from all studied cases (22 patients). All patients were under strict infection control practice and take the antibiotic treatment. Results: Nosocomial respiratory tract infections were the commonest (79.5%), followed by urinary tract infections (14.1%) in relation to other nosocomial infection. Acinetobacter infection was statistically significant among all the infections (P < 0.05). The mortality from acinetobacter infection group (1) was 50% and from colonization group (2) was 13.6% with overall mortality 30%. The antibiotics such as tigecyclin and colistin showed high curability and high sensitivity rate (p < 0.01). The mortality rate, comorbidities, ICU stays (days) after acinetobacter, CRP and WBCs were the significant predictors for group (1) patients. Conclusion: Acinetobacter baumannii is not so far as a cause of nosocomial respiratory infection with subsequent long ICU stays and high mortality. Emerging A. baumannii resistant strains is considered a real threat in ICU

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