title: Epidemiology of nosocomial colonization/infection caused by Acinetobacter spp. in patients of six surgical clinics in war and peacetime.
abstract: OBJECTIVE
  Acinetobacter spp. has emerged as nosocomial pathogen during the past few decades in hospitals all over the world, but it has increasingly been implicated as a serious nosocomial pathogen in military hospitals. The aim of this study was to analyse and compare the surveillance data on Acinetobacter nosocomial colonization/infection (NCI) collected during the wartime with the data collected in peacetime.
  
  
  METHODS
  We conducted a prospective study of incidence of Acinetobacter spp. colonization/infection. Also, the two nested case-control studies were conducted. The patients with nosocomial infection (cases) were compared with those with nosocomial colonization (controls) during the two different periods, wartime and peacetime. The patients with NCI by Acinetobacter spp. were identified by the case-based surveillance. The surveillance covered all the patients in 6 surgical clinics.
  
  
  RESULTS
  During the study periods a total of 166 patients had cultures that grew Acinetobacter spp. and the pooled rates of Acinetobacter spp. colonization and infection were significantly higher in wartime. When patients with NCI in wartime were compared with those with NCI in peacetime significant differences were observed. In the war year, the patients were more significantly males (p < 0.000). In a period of peace, most of the colonization/infections were reported from patients with certain chronic diseases (p = 0.020) and the survival of patients was more significant (p = 0.049). During the peacetime, proportions of Acinetobacter isolates resistent to ciprofloksacin, imipenem and meropenem were significantly higher (p < 0.001).
  
  
  CONCLUSIONS
  This study provides additional important information about the risk factors of nosocomial Acinetobacter spp. infections in a large cohort of surgical patients. This is also the first study that directly examines epidemiological differences between NCI caused by Acinetobacter spp. during the war and peace period.
authors: Military Medical Academy, Department of Infection Control, Belgrade, Serbia. pas@eunet.rs
authors: Vesna
authors: V
authors: Suljagić
authors: Miodrag
authors: M
authors: Jevtić
authors: Boban
authors: B
authors: Djordjević
authors: Predrag
authors: P
authors: Romić
authors: Radoje
authors: R
authors: Ilić
authors: Nebojsa
authors: N
authors: Stanković
authors: Novak
authors: N
authors: Milović
authors: Marijan
authors: M
authors: Novaković
authors: Jefta
authors: J
authors: Kozarski
authors: Zoran
authors: Z
authors: Roganović
authors: Zoran
authors: Z
authors: Popović
authors: Aleksandra
authors: A
authors: Jovelić
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D014857:Warfare; D055815:Young Adult