[Bacteremia caused by Acinetobacter baumannii among patients in critical care]. / Bacteremia por Acinetobacter baumannii en pacientes en estado crítico.

OBJECTIVE: Determine the severity and the course of Acinetobacter baumannii blood infections (AbBI). METHODS: We carried out a prospective review of all Acinetobacter baumannii (A. baumannii) isolated from the Intensive Care Unit (ICU) of a medical facility. RESULTS: During the study period, 46 patients were identified with AbBI. The rate of AbBI was 14 per 1,000 admissions. A. baumannii was ICU acquired in 85% of cases studied. The median time frame between ICU admission and acquisition of AbBI was 9 +/- 7 days. 31 patients displayed blood infection (BI) by A. baumannii alone and 15 with polymicrobial BI. The clinical manifestation of the 31 patients with AbBI included the following symptoms: 42% presented with septic shock, 42% had severe sepsis and 16% had sepsis. Two or more episodes of AbBI were observed among 13% of patients. Of A. baumannii isolates, 17% were resistant to imipenem. Patient mortality with AbBI alone was 45% and 40% for polymicrobial BI. Patient mortality for septic shock was 60%, 70% died during the first 72 hrs after AbBI. CONCLUSIONS: AbBI displayed an endemic pattern during the study period. Severe sepsis and septic shock were the most common clinical presentations of AbBI. AbBI are associated with a significant increase in the death rate of patient in the ICU studied.

Bacteremia por Acinetobacter baumannii en pacientes en estado crítico / Bacteremia caused by Acinetobacter baumannii among patients in critical care

Objetivo: Determinar la severidad y el comportamiento de las bacteremias por Acinetobacter baumannii (BAb). Métodos: Se revisaron de manera prospectiva todos los Acinetobacter baumannii aislados en una unidad de cuidados intensivos. Resultados: Se identificaron 46 pacientes con BAb y una tasa de BAb de 14 por mil ingresos. A. baumannii se adquirió en la unidad de cuidados intensivos en 85%. El periodo entre el ingreso y la BAb fue de 9±7 días. La BAb se presentó en 31 pacientes y bacteremia polimicrobiana en 15. Las manifestaciones clínicas de los 31 pacientes: choque séptico en 42%, sepsis severa en 42% y sepsis en 16%. Dos o más episodios de BAb ocurrieron en 13%. Se presentó resistencia a imipenem en 17% de los A. baumannii. La mortalidad para los pacientes con BAb fue de 45% y para bacteremia polimicrobiana de 40%. La mortalidad para los pacientes con choque séptico fue de 60%; 70% de los pacientes murió durante las primeras 72 horas seguidas a la BAb. Conclusiones: La distribución de los casos de BAb se presentó en forma continua con un patrón endémico. Sepsis severa y choque séptico fueron las principales manifestaciones de BAb. Las BAb se asocian con una tasa de mortalidad significativa.

OBJECTIVE: Determine the severity and the course of Acinetobacter baumannii blood infections (AbBI). METHODS: We carried out a prospective review of all Acinetobacter baumannii (A. baumannii) isolated from the Intensive Care Unit (ICU) of a medical facility. RESULTS: During the study period, 46 patients were identified with AbBI. The rate of AbBI was 14 per 1,000 admissions. A. baumannii was ICU acquired in 85% of cases studied. The median time frame between ICU admission and acquisition of AbBI was 9 +/- 7 days. 31 patients displayed blood infection (BI) by A. baumannii alone and 15 with polymicrobial BI. The clinical manifestation of the 31 patients with AbBI included the following symptoms: 42% presented with septic shock, 42% had severe sepsis and 16% had sepsis. Two or more episodes of AbBI were observed among 13% of patients. Of A. baumannii isolates, 17% were resistant to imipenem. Patient mortality with AbBI alone was 45% and 40% for polymicrobial BI. Patient mortality for septic shock was 60%, 70% died during the first 72 hrs after AbBI. CONCLUSIONS: AbBI displayed an endemic pattern during the study period. Severe sepsis and septic shock were the most common clinical presentations of AbBI. AbBI are associated with a significant increase in the death rate of patient in the ICU studied.