title: Acinetobacter infections in a tertiary level intensive care unit in northern India: epidemiology, clinical profiles and outcomes.
abstract: BACKGROUND
  Nosocomial Acinetobacter infections are an increasing concern in intensive care units (ICU).
  
  
  OBJECTIVE
  To study the demographic and clinical characteristics and the outcomes of ICU patients with Acinetobacter infections.
  
  
  METHODS
  A retrospective, 1-year audit of all Acinetobacter infections diagnosed in ICU patients between January 1 and December 31, 2009.
  
  
  RESULTS
  Acinetobacter infection occurred in 94 patients (108 episodes). The most common site of infection was the respiratory tract (83 patients, 76.85%), with medical patients being more susceptible than surgical patients to Acinetobacter lung infections (P=0.04), particularly late-onset ventilator-associated pneumonia (VAP) (P=0.04). The majority (63.8%) of infections were acquired in the ICU, and patients with ICU acquired infections were intubated significantly longer than the other patients (P=0.02). Seventy percent of the infections were caused by multidrug-resistant (MDR) strains, and the overall crude mortality rate was over 70%. The most important factors affecting mortality were the duration of intubation (P=0.001) and the inappropriate use of antibiotics (P=0.021) after diagnosis of the infection.
  
  
  CONCLUSIONS
  Acinetobacter infections are highly prevalent in the ICU, with medical patients being more susceptible to lung infections, particularly late-onset VAP. The early and appropriate selection of antibiotics is the most important determinant of survival among these patients.
authors.affiliation: Department of Anaesthesiology and Critical Care, Christian Medical College, Ludhiana, Punjab 141008, India. ashusatish.thomas@gmail.com
authors.forename: Ashu Sara
authors.initials: AS
authors.lastname: Mathai
authors.forename: Aroma
authors.initials: A
authors.lastname: Oberoi
authors.forename: Sheeba
authors.initials: S
authors.lastname: Madhavan
authors.forename: Parmdeep
authors.initials: P
authors.lastname: Kaur
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents