title: Carbapenem-resistant Acinetobacter baumannii in intensive care unit patients: risk factors for acquisition, infection and their consequences.
abstract: A retrospective case-control study was performed to assess risk factors and the clinical and economic consequences associated with acquisition of carbapenem-resistant Acinetobacter baumannii (CR-AB) in an intensive care unit (ICU) over a 24-month period. CR-AB was acquired by 64 of 1431 ICU admissions; each was matched with two controls. Risk factors associated with CR-AB acquisition included ICU-wide variables, such as 'colonization pressure' (the prevalence of ICU colonized patients) and ICU antibiotic use over the preceding three months, as well as patient-related variables. Among colonized patients, risk factors for CR-AB infection included transfusion and 'colonization density' (the proportion of body sites colonized with CR-AB). CR-AB infection was independently associated with increased hospital mortality [mortality difference: 20%; 95% confidence interval (CI): 1-40%], prolonged ICU stay (median length of stay difference: 15 days; 95% CI: 9-21 days) and prolonged hospital stay (30 days, 11-38 days) compared with matched controls.
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia. geoffrey_playford@health.qld.gov.au
authors.forename: E G
authors.initials: EG
authors.lastname: Playford
authors.forename: J C
authors.initials: JC
authors.lastname: Craig
authors.forename: J R
authors.initials: JR
authors.lastname: Iredell
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000472:pathogenicity; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015780:Carbapenems