title: Acinetobacter spp. colonization and infection risk factors in surgical patients.
abstract: BACKGROUND
  The results of numerous studies carried out over the last two decades have increasingly important cause of intrahospital infections (IHI). The aim of the study was to determine potential differences in distribution of individual risk factors between the group of patients in whom multiresistant Acinetobacter spp. was isolated and the group of patients in whom it was not.
  
  
  METHODS
  A prospective cohort study of 64 patients hospitalized with recorded IHI at the University Hospital for Digestive Surgery, Clinical Center of Serbia in the period between January and July 2011. The subjects were divided into two groups: patients with IHI in whom multiresistant Acinetobacter spp. was isolated from the biological material samples, and those with IHI without the presence of Acinetobacter spp.
  
  
  RESULTS
  Univariate data analysis indicated presence of statistically significant difference in distribution of certain types of surgeries (esophageal, pancreatic and hepatobiliary) among the two groups of subjects, distribution of CVC placement, application of mechanical ventilation and nasogastric tube placement, length of stay in ICU, lethal outcomes and administration of third generation cephalosporins. The results of multivariate analysis indicated that length of hospitalization in ICU (> 7 days), CVC, mechanical ventilation, esophageal, pancreatic and hepatobiliary surgeries as well as administration of third generation cephalosporins are independent risk factors for colonization and infection of patients with Acinetobacter spp.
  
  
  CONCLUSIONS
  Colonized or infected patients with Acinetobacter spp. play a major role in contamination of hands of the medical staff in the course of care and treatment, while inadequate hand hygiene of the staff leads to cross transmission of the causative organism to infection-free patients. Selective antibiotic pressure, particularly administration of quinolones and broad-spectrum cephalosporins, favor onset of multiresistant species of Acinetobacter spp., and therefore appropriate prophylaxis and treatment represent basic preventive measures against the onset and spreading of the causative organisms.
authors.affiliation: Department of hospital epidemiology and hygiene, Clinical Center of Serbia, Belgrade.
authors.forename: Vesna
authors.initials: V
authors.lastname: Mioljević
authors.forename: Aleksandar P
authors.initials: AP
authors.lastname: Simić
authors.forename: Dejan
authors.initials: D
authors.lastname: Radenković
authors.forename: Danijel
authors.initials: D
authors.lastname: Galun
authors.forename: Ivan
authors.initials: I
authors.lastname: Palibrk
authors.forename: Slavenko
authors.initials: S
authors.lastname: Ostojić
authors.forename: Dejan
authors.initials: D
authors.lastname: Stojakov
authors.forename: Zorica
authors.initials: Z
authors.lastname: Varagić
authors.forename: Milorad
authors.initials: M
authors.lastname: Pavlović
authors.forename: Miroslav N
authors.initials: MN
authors.lastname: Milićević
mesh_terms: D000150:Acinetobacter / Q000187:drug effects* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000209:etiology* / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology*; D013505:Digestive System Surgical Procedures; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000382:microbiology*; D012307:Risk Factors