title: Risk factors for acquisition of multidrug-resistant Acinetobacter baumannii among cancer patients.
abstract: BACKGROUND
  Data regarding multidrug-resistant (MDR) Acinetobacter baumannii infections among cancer patients are limited.
  
  
  METHODS
  We conducted a case-control study to investigate the risk factors for acquisition of MDR A baumannii and the outcomes among cancer patients. Cases were inpatients with malignancy who had MDR A baumannii from any cultures between 2008 and 2011. Controls were inpatients with malignancy but no MDR A baumannii.
  
  
  RESULTS
  A total of 31 case patients were matched with 62 control patients. Hematologic malignancy (P = .036), need for dialysis (P = .01), admission for other reasons except elective surgery (P = .03), transfer from other health care facilities (P = .02), prolonged intensive care unit stay (P = .004), mechanical ventilation (P < .001), pressor use (P = .001), tube feeding (P < .001), transfusion (P = .009), and prior antimicrobial use (P < .001) were identified as significant risk factors in univariate analysis. Need for dialysis (odds ratio [OR], 18.23; P = .04) and prolonged intensive care unit stay (OR, 19.28; P = .01) remained significant in multivariate analysis. Lengths of stay were 28 days for the case patients and 10 days for the control patients (P = .001). The 90-day mortality rates were 41.9% and 29.0%, respectively (P = .20).
  
  
  CONCLUSIONS
  Acquisition of MDR A baumannii among cancer patients appears to be associated with general nosocomial infection risk factors rather than underlying malignancies.
authors.affiliation: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Fukuta
authors.forename: Robert R
authors.initials: RR
authors.lastname: Muder
authors.forename: Mounzer E
authors.initials: ME
authors.lastname: Agha
authors.forename: Lloyd G
authors.initials: LG
authors.lastname: Clarke
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Wagener
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Hensler
authors.forename: Yohei
authors.initials: Y
authors.lastname: Doi
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification*; D000368:Aged; D016022:Case-Control Studies; D003428:Cross Infection / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012307:Risk Factors
keywords: Case-control study; Clinical outcome; Colonization; Infection; Malignancy