[Multidrug resistant Acinetobacter baumanii:clinical update and new highlights].
The role of multidrug resistant Acinetobacter baumanii and its clinical relevance have been recently appreciated as a ubiquitous opportunistic nosocomial pathogen. Risk factors associated with A. baumanii infection include severe underlying diseases, previous surgery, invasive procedures, treatment with broad-spectrum antibiotics, length of hospital stay, admission to intensive care units (ICU). Carbapenem-multidrug resistant A. baumanii infections are probably associated to greater severity and more complications; in our cohort mortality was 49.3% and related mortality (within 72 hours) was 10.39%. However, severe underlying diseases probably play an important role in the clinical outcome of patients with MDR-C A. baumanii infection and controversy exists regarding the real mortality attributable to antimicrobial resistance because a high proportion of deaths took place > 7 days after diagnosis. Nevertheless, in our experience, carbapenem resistance, inappropriate therapy and monotherapy are associated to a higher mortality. Special attention should be paid to design well-controlled prospective clinical trials to determine the optimal antimicrobial therapy in critically ill patients suspected of having MDR Acinetobacter infection.
Servicio de MI Infecciosas. Hospital Universitario, Virgen de la Arrixaca. Murcia, Spain. maliht_1@hotmail.com
Hernández A
HA
Torres
E García
EG
Vázquez
G
G
Yagüe
J Gómez
JG
Gómez
D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008826:Microbial Sensitivity Tests; D011379:Prognosis; D012307:Risk Factors
D000900:Anti-Bacterial Agents
Acinetobacter baumanii multirresistente:situación clínica actual y nuevas perspectivas.