title: Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii.
abstract: BACKGROUND
  A. baumannii is an important nosocomial pathogen associated with high mortality, morbidity and medical cost.
  
  
  OBJECTIVE
  The aim of this study was to investigate risk factors for MDR A. baumannii bacteremia and also evaluate cost of hospitalization of these patients.
  
  
  METHODS
  Study was conducted in Ankara Atatürk Training and Research Hospital. Patients who were hospitalized in ICU and diagnosed for nosocomial blood stream infection (BSI) between January 2007 and December 2010 were checked retrospectively. Patients with nosocomial BSI caused by multidrug resistant A. baumannii were compared with the patients who had BSI caused by other Gram-negative microorganisms in terms of risk factors, mortality and medical costs.
  
  
  RESULTS
  In multivariate analysis previous use of carbapenem, quinolone and metronidazole, and SAPS II score were found as independent risk factors. In case group; immunosupression, SAPS II score, and hospital stay until infection were independently associated with mortality in multivariate analysis.
  
  
  CONCLUSIONS
  Our results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Nigde State Hospital, Nigde, Turkey. Electronic address: tarslan81@yahoo.com.tr.
authors.forename: Tugba Arslan
authors.initials: TA
authors.lastname: Gulen
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Rahmet
authors.initials: R
authors.lastname: Guner
authors.affiliation: Department of Medical Microbiology, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Nevreste
authors.initials: N
authors.lastname: Celikbilek
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Giresun University Faculty of Medicine, Giresun, Turkey.
authors.forename: Siran
authors.initials: S
authors.lastname: Keske
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tasyaran
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Acinetobacter baumannii; cost; multi-drug resistance