title: Comparison of risk factors for recovery of Acinetobacter baumannii during outbreaks at two Kentucky hospitals, 2006.
abstract: OBJECTIVE
  Acinetobacter baumannii (A. baumannii) is a well-described cause of nosocomial outbreaks and can be highly resistant to antimicrobials. We investigated A. baumannii outbreaks at two Kentucky hospitals to find risk factors for Acinetobacter acquisition in hospitalized patients.
  
  
  METHODS
  We performed case-control studies at both hospitals. We defined a case as a clinical culture growing A. baumannii from a patient from August 1 to October 31, 2006 (Hospital A), or April 1 to October 31, 2006 (Hospital B).
  
  
  RESULTS
  Twenty-nine cases were identified at Hospital A and 72 cases were identified at Hospital B. The median case patient age was 42 years in Hospital A and 46 years in Hospital B. The majority of positive cultures were from sputum (Hospital A, 51.7%; Hospital B, 62.5%). The majority of case patients had multidrug-resistant A. baumannii (Hospital A, 75.9%; Hospital B, 70.8%). Using logistic regression, controlling for age and admitting location, mechanical ventilation (Hospital A odds ratio [OR] = 21.6; 95% confidence interval [CI] 3.5, 265.9; Hospital B OR = 4.5, 95% CI 1.9, 11.1) was associated with A. baumannii recovery. Presence of a nonsurgical wound (OR = 6.6, 95% CI 1.2, 50.8) was associated with recovery of A. baumannii at Hospital A.
  
  
  CONCLUSIONS
  We identified similar patient characteristics and risk factors for A. baumannii acquisition at both hospitals. Our findings necessitate the importance of review of infection control procedures related to respiratory therapy and wound care.
authors.affiliation: Kentucky Department for Public Health, Frankfort, KY, USA. SBeavers@cdc.gov
authors.forename: Suzanne F
authors.initials: SF
authors.lastname: Beavers
authors.forename: David B
authors.initials: DB
authors.lastname: Blossom
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Wiemken
authors.forename: Kelly Y
authors.initials: KY
authors.lastname: Kawaoka
authors.forename: Andrew
authors.initials: A
authors.lastname: Wong
authors.forename: Linda
authors.initials: L
authors.lastname: Goss
authors.forename: Malkanthie I
authors.initials: MI
authors.lastname: McCormick
authors.forename: Douglas
authors.initials: D
authors.lastname: Thoroughman
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007223:Infant; D007629:Kentucky / Q000453:epidemiology; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects; D012307:Risk Factors; D014947:Wounds and Injuries / Q000382:microbiology; D055815:Young Adult