Clinical Characteristics and Prognosis of Acinetobacter Nosocomial Pneumonia between MDR and non-MDR / 결핵및호흡기질환

ABSTRACT

BACKGROUND: Acinetobacter baumannii has emerged as an important nosocomial pathogen worldwide. The incidence of these infections has recently begun to increase. The mortality rate associated with these infections is high (bacteremia; 52% , pneumonia 23%~73%) and multidrug resistance has been reported. For the effective control of multidrug- resistant Acinetobacter baumannii(MDR-AB), the impact of these organisms in clinical practice should be determined. This study compared the clinical characteristics, mortality and morbidity of Acinetobacter nosocomial pneumonia between MDR strain and non-MDR strain. METHODS: From Jan. 1, 2002 to Nov. 1. 2004, 47 adult patients with Acinetobacter nosocomial pneumonia in Chuncheon Sacred Heart Hospital were recruited and analyzed retrospectively. MDR-AB was defined as showing in vitro resistance to all commercially available antibiotics against A. baumannii. RESULTS: There were 47 patients with Acinetobacter nosocomial pneumonia. MDR-AB and non MDR-AB was the cause of the pneumonia in 17 and 30 patients, respectively. Mean age of the former was 69+/-11 years old and the latter was 70+/-13 years old. The mean APCHE II score, ICU days and mortality were not different between the two groups(16.1+/-5.4 vs. 14.9+/-4.8, P=0.43, 25.1+/-13.6 vs. 39.1+/-31.0, P=0.2, 58.8% vs. 40%, P=0.21). CONCLUSION: There are no significant differences in mortality and morbidity between MDR and non-MDR Acinetobacter baumannii. The mortality of the two groups is surprisingly high, therefore proper infection control practices are essential.