title: Risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii in Spain: a nationwide study.
abstract: Potential risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii were investigated in a cohort study in 25 Spanish hospitals. The clonal relationship among isolates was determined by pulsed-field gel electrophoresis (PFGE). In total, A. baumannii was isolated from 203 patients, with imipenem-resistant (MIC(90) 128 mg/L) isolates being obtained from 88 patients (43%), and imipenem-susceptible isolates from 115 patients (57%). A wide clonal distribution was observed among the imipenem-resistant isolates, but spread of the same clone among centres was not demonstrated. The results indicated that imipenem-resistant A. baumannii is a widely distributed nosocomial pathogen in Spain and reaches an alarming frequency in some centres. Independent risk-factors for the acquisition of imipenem-resistant A. baumannii were a hospital size of >500 beds (multivariate OR, 6.5; 95% CI, 1.8--23), previous antimicrobial treatment (multivariate OR, 4.3; 95% CI, 1.6--11), a urinary catheter (multivariate OR, 2.7; 95% CI, 1.1--6.7) and surgery (multivariate OR, 2; 95% CI, 1.07--3.8).
authors.affiliation: Infectious Disease Service, University Hospital Virgen del Rocío, Sevilla, Spain. cisnerosjm@telefonica.net
authors.forename: J M
authors.initials: JM
authors.lastname: Cisneros
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.forename: F
authors.initials: F
authors.lastname: Fernández-Cuenca
authors.forename: A
authors.initials: A
authors.lastname: Ribera
authors.forename: J
authors.initials: J
authors.lastname: Vila
authors.forename: A
authors.initials: A
authors.lastname: Pascual
authors.forename: L
authors.initials: L
authors.lastname: Martínez-Martínez
authors.forename: G
authors.initials: G
authors.lastname: Bou
authors.forename: J
authors.initials: J
authors.lastname: Pachón
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D018562:Disease Transmission, Infectious; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006742:Hospital Bed Capacity; D006761:Hospitals; D006801:Humans; D015378:Imipenem / Q000494:pharmacology* / Q000627:therapeutic use; D007297:Inpatients; D012307:Risk Factors; D013030:Spain; D013530:Surgical Wound Infection
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D015378:Imipenem