Nosocomial multi-drug resistant Acinetobacter baumannii bloodstream infection: risk factors and outcome with ampicillin-sulbactam treatment.
J Hosp Infect
; 54(1): 32-8, 2003 May.
Article
em En
| MEDLINE
| ID: mdl-12767844
ABSTRACT
The emergence of multidrug-resistant (MDR) Acinetobacter baumannii poses a therapeutic problem. The aim of this study was to assess the risk factors for nosocomial MDR-A. baumannii bloodstream infection (BSI) and the efficacy of ampicillin-sulbactam (A/S) in its treatment. Of 94 nosocomial A. baumannii BSI during the year 2000, 54% involved MDR strains, 81% of which were genetically related. Various risk factors for MDR-A. baumannii were found, of which intensive-care unit admission and prior aminoglycoside therapy were independently associated with MDR-A. baumannii acquisition on multivariate analysis. Of MDR-A. baumannii BSI cases, 65% received A/S and 35% inadequate antibiotic therapy, whereas of 43 non-MDR cases, 86% were treated according to susceptibility and 14% inappropriately with antibiotics to which these organisms were resistant. Crude mortality was comparable in the adequately treated groups. Respective mortalities among patients treated adequately and inadequately were 41.4 and 91.7% (p<0.001). Among severely ill patients, A/S therapy significantly decreased the risk of death (P=0.02 OR=7.64). MDR-A. baumannii has become highly endemic in our institution. A/S appears to be one of the last effective and safe empirical resorts for treatment of MDR A. baumannii BSI.
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Base de dados:
MEDLINE
Métodos Terapêuticos e Terapias MTCI:
Plantas_medicinales
Assunto principal:
Infecções por Acinetobacter
/
Sulbactam
/
Avaliação de Resultados em Cuidados de Saúde
/
Farmacorresistência Bacteriana Múltipla
/
Acinetobacter baumannii
/
Quimioterapia Combinada
/
Ampicilina
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Hosp Infect
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Israel