title: Epidemiological monitoring of nosocomial infections caused by acinetobacter baumannii.
abstract: BACKGROUND
  Acinetobacter baumannii is a frequent cause of infections in hospitals around the world, which is very difficult to control and treat. It is particularly prevalent in intensive care wards.
  
  
  OBJECTIVE
  The main objective of the research was to establish the application of epidemiological monitoring of nosocomial infections (NIs) caused by A. baumannii in order to determine: the type and distribution of NIs, and to investigate antimicrobial drug resistance of A. baumannii.
  
  
  METHODS
  855 patients treated at the Clinic of Anesthesiology and Reanimation, University Clinical Center Tuzla during 2013 were followed prospectively for the development of NIs. Infections caused by A. baumannii were characterized by the anatomical site and antibiotics resistance profile.
  
  
  RESULTS
  NIs were registered in 105 patients (12.3%; 855/105). The predominant cause of infection was A. baumannii with an incidence of 51.4% (54/105), followed by ESBL-producing Klebsiella pneumoniae with 15.2% (16/105) of cases, methicillin-resistant Staphylococcus aureus with 8.6% (9/105), and ESBL-producing Proteus mirabilis with 7.6% (8/105). According to the anatomical site, and type of NIs caused by A. baumannii, the most frequent were respiratory infections (74.1%; 40/54). Infections of surgical sites were registered in 11.1% (6/54) of cases, while bloodstream infections in 9.2% (5/54). A. baumannii isolates tested resistant against most antibiotics examined, but showed a high degree of susceptibility to tobramycin (87%; 47/54) and colistin (100%; 54/54).
  
  
  CONCLUSIONS
  The increasing incidence of multi- and extensively drug-resistant Acinetobacter spp. emphasizes the importance of administration of an adequate antibiotic strategy and the implementation of strict monitoring of the measures for controlling nosocomial infections.
authors: Department for Hygiene and Epidemiology Surveillance. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Amer
authors: A
authors: Custovic
authors: Institute of Microbiology, Polyclinic for Laboratory Diagnostics. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Jasmina
authors: J
authors: Smajlovic
authors: Institute of Microbiology, Polyclinic for Laboratory Diagnostics. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Nijaz
authors: N
authors: Tihic
authors: Department for Hygiene and Epidemiology Surveillance. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Sadeta
authors: S
authors: Hadzic
authors: Clinic of Infectious Diseases. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Sead
authors: S
authors: Ahmetagic
authors: The Clinic of Anesthesiology and Reanimation. University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors: Haris
authors: H
authors: Hadzagic
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017522:Bosnia and Herzegovina; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology*; D024901:Drug Resistance, Multiple, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acinetobacter baumannii; intensive care unit; multidrug resistance; nosocomial infections
references: Infect Control Hosp Epidemiol. 2003 Apr;24(4):284-95
references: 12725359
references: Am J Med Qual. 2009 May-Jun;24(3):205-13
references: 19332864
references: Infect Control Hosp Epidemiol. 2007 Nov;28(11):1247-54
references: 17926275
references: Infect Control Hosp Epidemiol. 2007 May;28(5):602-5
references: 17464924
references: J Clin Microbiol. 1997 Jun;35(6):1394-7
references: 9163451
references: Pol Przegl Chir. 2013 Sep;85(9):483-90
references: 24133105
references: Clin Infect Dis. 2006 Mar 1;42(5):692-9
references: 16447117
references: New Microbiol. 2008 Oct;31(4):535-42
references: 19123310
references: Infect Control Hosp Epidemiol. 2009 Mar;30(3):257-63
references: 19199531
references: Clin Microbiol Rev. 1996 Apr;9(2):148-65
references: 8964033
references: J Antimicrob Chemother. 2012 Jul;67(7):1607-15
references: 22441575
references: Clin Infect Dis. 2005 Sep 15;41(6):848-54
references: 16107985
references: N Engl J Med. 2008 Mar 20;358(12):1271-81
references: 18354105
references: Ann Clin Microbiol Antimicrob. 2004 Jul 29;3:14
references: 15283864
references: Infect Control Hosp Epidemiol. 1989 Sep;10(9):402-7
references: 2794465
references: Clin Infect Dis. 2008 Apr 15;46(8):1254-63
references: 18444865
references: J Hosp Infect. 2004 Feb;56(2):101-5
references: 15019220