title: Hospital outbreak caused by a carbapenem-resistant strain of Acinetobacter baumannii: patient prognosis and risk-factors for colonisation and infection.
abstract: Between October 2001 and August 2002, 30 hospital patients became infected or colonised by a multiresistant (including to carbapenems) epidemic strain of Acinetobacter baumannii (AbMR) in a hospital outbreak. This study analysed the risk-factors associated with acquisition of this epidemic strain and investigated the prognosis of patients infected by AbMR, with the aim of elucidating factors which lead to mortality. A case-control study of the acquisition of AbMR in patients infected or colonised in the hospital outbreak was performed. Independent risk-factors leading to death were studied by logistic regression analysis. Multivariate analysis of the risk-factors for colonisation/infection with AbMR revealed an independent association with the presence of an arterial catheter (OR, 1.13; 95% CI, 1.03-1.25) and administration of imipenem as monotherapy (OR, 11.12; 95% CI, 2.33-53.09). Multivariate analysis of the prognostic features leading to mortality revealed a significant association with hypotension or shock (OR, 24.63; 95% CI, 1.56-387.56) at the time of bacterial isolation.
authors.affiliation: Servicio de Microbiologia, Complejo Hospitalario Universitario Juan Canalego, La Coruna, Spain.
authors.forename: M
authors.initials: M
authors.lastname: del Mar Tomas
authors.forename: M
authors.initials: M
authors.lastname: Cartelle
authors.forename: S
authors.initials: S
authors.lastname: Pertega
authors.forename: A
authors.initials: A
authors.lastname: Beceiro
authors.forename: P
authors.initials: P
authors.lastname: Llinares
authors.forename: D
authors.initials: D
authors.lastname: Canle
authors.forename: F
authors.initials: F
authors.lastname: Molina
authors.forename: R
authors.initials: R
authors.lastname: Villanueva
authors.forename: J M
authors.initials: JM
authors.lastname: Cisneros
authors.forename: G
authors.initials: G
authors.lastname: Bou
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology*; D016022:Case-Control Studies; D002406:Catheterization, Peripheral; D003428:Cross Infection / Q000382:microbiology*; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007022:Hypotension; D015378:Imipenem / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012769:Shock; D013030:Spain
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D015378:Imipenem