[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.
Torres
Hernández A
HA
Servicio de MI Infecciosas. Hospital Universitario, Virgen de la Arrixaca. Murcia, Spain. maliht_1@hotmail.com
Vázquez
E García
EG
Yagüe
G
G
Gómez
J Gómez
JG
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.