title: Risk factors and outcomes in patients with carbapenem-resistant Acinetobacter infection.
abstract: BACKGROUND
  Acinetobacter spp. are important pathogens increasingly reported as the cause of outbreaks of nosocomial infections. The aim of our study was to identify the risk factors and assess their influence on outcomes in patients with infections caused by carbapenem-resistant Acinetobacter spp.
  
  
  METHODS
  A retrospective data analysis was performed to evaluate risk factors and mortality in patients with Acinetobacter spp. infections. Methods used for the statistical analysis were the Student's t-test, Chi-square test, and multivariate analysis; p < 0.05 was considered statistically significant.
  
  
  RESULTS
  A total of 99 patients with an Acinetobacter spp. infection were identified. Comparing patients with carbapenem-sensitive and carbapenem-resistant Acinetobacter spp. infection, significant differences were found in the mean length of intensive care unit stay (4.17 ± 3.61 vs 7.92 ± 6.74 days, p = 0.038) and mechanical ventilation (3.25 ± 2.61 and 7.07 ± 5.79 days, p = 0.009). The previous use of carbapenems (odds ratio (OR) 10.1, 95% confidence interval (CI) 1.16-87.20) and fluoroquinolones (OR 3.6, 95% CI 1.13-11.51) was independently associated with resistance to carbapenems. Of the Acinetobacter spp. strains, 94.9% (n = 94) were resistant to piperacillin-tazobactam, 88.9% (n = 88) to ceftazidime, 85.9% (n = 85) to ciprofloxacin, 83.8% (n = 83) to gentamicin, 79.8 (n = 79) to amikacin, and 48.5% (n = 48) to cefepime.
  
  
  CONCLUSIONS
  Intensive care unit stay before infection and source of infection in the respiratory tract were independently associated with patient mortality. Resistance to carbapenems had no impact on mortality rates. Carbapenem-resistant Acinetobacter spp. isolates had high resistance rates to other antimicrobial drugs.
authors.affiliation: Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. astravitka@hotmail.com
authors.forename: Astra
authors.initials: A
authors.lastname: Vitkauskiene
authors.forename: Asta
authors.initials: A
authors.lastname: Dambrauskiene
authors.forename: Kristina
authors.initials: K
authors.lastname: Cerniauskiene
authors.forename: Rytis
authors.initials: R
authors.lastname: Rimdeika
authors.forename: Raimundas
authors.initials: R
authors.lastname: Sakalauskas
mesh_terms: D000150:Acinetobacter / Q000187:drug effects* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems