title: Prospective study of antibacterial susceptibility, risk factors and outcome of 157 episodes of Acinetobacter baumannii bacteremia in 1999 in Slovakia.
abstract: This study prospectively investigated all 157 cases of Acinetobacter baumannii bacteremia occurring in major university hospitals or tertiary care institutions in Slovakia during 1999 in order to determine the antimicrobial susceptibility, risk factors and outcome. Resistance to meropenem was 7.4, gentamicin 35.6, amikacin 26.5, cefepime 20.4 and ciprofloxacin 32.7%, but was only 17.3% to cefoperazone/sulbactam or ampicillin/sulbactam. Antimicrobial susceptibility of A. baumanii was lowest among isolates from cancer patients (ceftazidime 58%, piperacillin/tazobactam 52% and azthreonam 48%; p < or = 0.01-0.001). In univariate analysis, several risk factors, such as wound infection (p < or = 0.01) and ventilatory support (p < or = 0.0001), were significantly related to A. baumannii bacteremia in surgical patients. Neutropenia (p < or = 0.0001), antineoplastic chemotherapy (p < or = 0.0001) and prior antibiotic therapy (p < or = 0.0006) were significant risk factors for A. baumannii bacteremia in cancer patients. In addition, ventilatory support and surgery (p < or = 0.0001) and prior antibiotic therapy (p < or = 0.01) were significantly related to A. baumannii bacteremia in children. Colonization at other body sites (p < or = 0.05), diabetes mellitus (p < or = 0.04) and decubital ulcers/burns (p < or = 0.002) as underlying disease were significantly related to death due to A. baumannii bacteremia. In a multiple logistic regression model, decubital ulcers/burns as underlying disease (p < or = 0.0006; relative risk 5.08) and nosocomial pneumonia (p < or = 0.045; relative risk 5.08) were independent predictors of mortality. Mortality was similar between cancer and surgical patients but significantly lower in children vs. adults (p < or = 0.009).
authors.affiliation: Department of Public Health, School of Health, University of Trnava, Slovakia.
authors.forename: J
authors.initials: J
authors.lastname: Koprnová
authors.forename: I
authors.initials: I
authors.lastname: Svetlanský
authors.forename: R
authors.initials: R
authors.lastname: Babel'a
authors.forename: E
authors.initials: E
authors.lastname: Bilíková
authors.forename: J
authors.initials: J
authors.lastname: Hanzen
authors.forename: I J
authors.initials: IJ
authors.lastname: Zuscáková
authors.forename: V
authors.initials: V
authors.lastname: Mílovský
authors.forename: O
authors.initials: O
authors.lastname: Masár
authors.forename: G
authors.initials: G
authors.lastname: Kovacicová
authors.forename: M
authors.initials: M
authors.lastname: Gogová
authors.forename: P
authors.initials: P
authors.lastname: Koren
authors.forename: M
authors.initials: M
authors.lastname: Rusnák
authors.forename: A
authors.initials: A
authors.lastname: Lisková
authors.forename: V
authors.initials: V
authors.lastname: Zák
authors.forename: M
authors.initials: M
authors.lastname: Karvaj
authors.forename: K
authors.initials: K
authors.lastname: Kanik
authors.forename: A
authors.initials: A
authors.lastname: Strehár
authors.forename: M
authors.initials: M
authors.lastname: Lesay
authors.forename: Z
authors.initials: Z
authors.lastname: Szöveniová
authors.forename: J
authors.initials: J
authors.lastname: Trupl
authors.forename: A
authors.initials: A
authors.lastname: Purgelová
authors.forename: K
authors.initials: K
authors.lastname: Kralinský
authors.forename: A
authors.initials: A
authors.lastname: Roidová
authors.forename: J
authors.initials: J
authors.lastname: Lamosová
authors.forename: M
authors.initials: M
authors.lastname: Huttová
authors.forename: V
authors.initials: V
authors.lastname: Krcméry
mesh_terms: D000150:Acinetobacter / Q000187:drug effects* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D018154:Slovakia / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents