Outbreak of resistant Acinetobacter baumannii: measures and proposal for prevention and control
Braz. j. infect. dis
; 13(5): 341-347, Oct. 2009. tab, ilus
Article
in English
| LILACS
| ID: lil-544986
Responsible library:
BR1.1
ABSTRACT
Acinetobacter baumannii colonization and infection, frequent in Intensive Care Unit (ICU) patients, is commonly associated with high morbimortality. Several outbreaks due to multidrug-resistant (MDR) A. baumanii have been reported but few of them in Brazil. This study aimed to identify risk factors associated with colonization and infection by MDR and carbapenem-resistant A. baumannii strains isolated from patients admitted to the adult ICU at HC/UFMG. A case-control study was performed from January 2007 to June 2008. Cases were defined as patients colonized or infected by MDR/carbapenem-resistant A. baumannii, and controls were patients without MDR/carbapenem-resistant A. baumannii isolation, in a 12 proportion. For statistical analysis, due to changes in infection control guidelines, infection criteria and the notification process, this study was divided into two periods. During the first period analyzed, from January to December 2007, colonization or infection by MDR/carbapenem-resistant A. baumannii was associated with prior infection, invasive device utilization, prior carbapenem use and clinical severity. In the multivariate analysis, prior infection and mechanical ventilation proved to be statistically significant risk factors. Carbapenem use showed a tendency towards a statistical association. During the second study period, from January to June 2008, variables with a significant association with MDR/carbapenem-resistant A. baumannii colonization/infection were catheter utilization, carbapenem and third-generation cephalosporin use, hepatic transplantation, and clinical severity. In the multivariate analysis, only CVC use showed a statistical difference. Carbapenem and third-generation cephalosporin use displayed a tendency to be risk factors. Risk factors must be focused on infection control and prevention measures considering A. baumanni dissemination.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Acinetobacter Infections
/
Carbapenems
/
Cross Infection
/
Disease Outbreaks
/
Beta-Lactam Resistance
/
Drug Resistance, Multiple, Bacterial
/
Acinetobacter baumannii
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2009
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Grupo de Estudo e Pesquisas em Infecção Associada ao Cuidado de Saúde e Epidemiologia Hospitalar/BR
/
Universidade Federal de Minas Gerais/BR