1583. Adult Intensive Care Unit Acquired Nosocomial Multi-Drug Resistant Acinetobacter Infections: Epidemiology, Risk Factors and Genotyping Analysis
Session: Poster Abstract Session: Multidrug-Resistant Gram Negative Rods
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Presentation Number1583.pdf (2.8 MB)
  • Background:

    We aimed in this study to identify risk factors which thought to be influential in the development of nosocomial multi-drug-resistant Acinetobacter baumanni infection in adult intensive care units and genotyping of isolates.

    Methods:

    This research is being a prospective case-control study tried to determine risk factors which are thought to play a role in the development of infection compared with nosocomial Acinetobacter infection attacks were determined with 108 cases and 105 patients were in control group with any infection are being followed during the same periods between April 2011-March 2012. The risk factors are identified with analysis of univariate and multivariate logistic regression. Repetitive Extragenic Palindromic-Polymerase Chain Reaction based Diversilab System  (Biomerieux, France) was used to research clonal relation between A. baumanni strains. 

    Results:

    Age (OR=1.03, 95% CI=1.00 to 1.05, p=0.008), application of mechanical ventilation (OR=5.68, 95% CI=2.53 to 12.72, p=0.0001), tracheotomy (OR=5.29, 95% CI=1.64 to 17.08, p=0.005), percutan enterogastrostomi (OR=9.49, 95% CI=2.41 to 37.27, p=0.001) and a history of using carbapenem (OR=6.02, 95% CI=2.42 to 14.94, p=0.0001) and non-using cephalosporin (OR=0.11, 95% CI=0.02 to 0.49, p=0.004) was found to be an independent risk factor for nosocomial Acinetobacter infection. Multiple antibiotic resistance was determined in 94% of the isolates. All isolates were susceptible to colistin. Tigecycline susceptibility was determined as %99,1. Eighty-three of 96 genotyped isolates were in 24 different-cluster. According to genotyping results there was no dominant epidemic clone. Clustering ratio, an indicator of propinquity between clonal isolates, was found to be %86.

    Conclusion:

    In our study were observed that the clone which have a several number of isolates continued existence of the hospital was approximately 14 months. This data suggests that multi-drug resistant Acinetobacter clone can remain for many years in the hospital environment and can transmitted from patient-to-patinet if precautions are not taken. Restriction of implementation of broad-spectrum antibiotics such as carbapenems especially in patients who do not need can reduce the rate of nosocomial infections due to Acinetobacter baumanni.

    Sirvan Elmas Dal, Funda Yetkin, Baris Otlu, Cigdem Kuzucu and Yasemin Ersoy, Inonu University Faculty of Medicine, Malatya, Turkey

    Disclosures:

    S. Elmas Dal, None

    F. Yetkin, None

    B. Otlu, None

    C. Kuzucu, None

    Y. Ersoy, None

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