Objectives
Acinetobacter baumannii recently has emerged as an important nosocomial pathogen.
The aim of this study was to assess the impact on mortality of multidrug-resistant
A. baumannii (MDR-AB) infection/colonization in patients undergoing cardiac surgery
and to investigate microbiologic characteristics, epidemiologic spread of this pathogen,
and the relative containment measures.
Design
Single-center, retrospective cohort study of prospectively collected data.
Setting
Cardiac surgery tertiary-care center.
Participants
Patients with positive MDR-AB cultures from September 1, 2009 to December 31, 2011.
Interventions
Bivariate and multivariate analyses were performed to individualize the risk factors
for MDR-AB-infections in cardiac surgery patients. To evaluate the MDR-AB attributable
mortality, a retrospective matched cohort study was performed. Incidence density ratio
(IDR) was calculated to compare the MDR-AB infection/colonization before and after
the introduction of preventive measures adopted following the first cases.
Measurements and Main Results
MDR-AB acquisition occurred in 14 patients (0,6%) of 2385 patients. At the multivariate
analyses, preoperative use of inotropic drugs (OR 18.2, 95% CI 4.6-71.9) and logistic
EuroSCORE (OR 1.09, 95% CI 1.06-1.13) were found as independent risk factors. Patients
with MDR-AB had 57% cumulative in-hospital mortality; no statistical differences in
mortality were observed in the matched group. IDR revealed a significantly decreased
incidence of infection/colonization (0.3 per 1,000 days of stay compared with 0.03/1,000
days of stay, p = 0.0001) after the containment measures became effective.
Conclusions
Sicker patients are more susceptible to be infected by A. baumannii, but mortality
is not significantly higher compared with other patients with similar characteristics.
Adequate measures are fundamental to control the spread of the infection.
Key Words
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Article info
Publication history
Published online: December 21, 2015
Identification
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© 2015 Elsevier Inc. All rights reserved.
