title: Mortality attributable to carbapenem-resistant nosocomial Acinetobacter baumannii infections in a Turkish university hospital.
abstract: This study was performed to compare the mortality associated with  carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-sensitive A. baumannii (CSAB)  infections, to identify potential risk factors for CRAB infections, and to investigate the effects  of potential risk factors on mortality in CRAB and CSAB patients. This retrospective case-control  study was conducted in a university hospital between January 1, 2005 and December 30, 2006. One  hundred and ten patients with CRAB and 55 patients with CSAB infection were identified during the  study period. The mortality rate was 61.8% and 52.7% in CRAB and CSAB cases, respectively  (P = 0.341). In CRAB cases, the risk factors for mortality were identified as intubation (odds  ratio [OR], 3.3; 95% confidence interval [CI], 1.0-10.1; P = 0.042) and high APACHE II score (OR,  1.2; 95% CI, 1.1-1.3; P = 0.000), by multivariate analysis. Previous use of carbapenem (OR, 6.1;  95% CI, 2.2-17.1; P = 0.001) or aminopenicillin (OR, 2.5; 95% CI, 1.2-5.1; P = 0.013) were  independently associated with carbapenem resistance. Although the mortality rate was higher among  patients with CRAB infections, this difference was not found to be statistically significant.  Previous use of carbapenem and aminopenicillin were found to be independent risk factors for  infections with CRAB.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Zonguldak Karaelmas University Medical Faculty, Zonguldak, Turkey. drhaydemir@yahoo.com
authors.forename: Hande
authors.initials: H
authors.lastname: Aydemir
authors.forename: Guven
authors.initials: G
authors.lastname: Celebi
authors.forename: Nihal
authors.initials: N
authors.lastname: Piskin
authors.forename: Nefise
authors.initials: N
authors.lastname: Oztoprak
authors.forename: Aysegul Seremet
authors.initials: AS
authors.lastname: Keskin
authors.forename: Elif
authors.initials: E
authors.lastname: Aktas
authors.forename: Vildan
authors.initials: V
authors.lastname: Sumbuloglu
authors.forename: Deniz
authors.initials: D
authors.lastname: Akduman
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000472:pathogenicity*; D000368:Aged; D000369:Aged, 80 and over; D015780:Carbapenems / Q000008:administration & dosage / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010406:Penicillins / Q000008:administration & dosage / Q000494:pharmacology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D015780:Carbapenems; D010406:Penicillins