Risk Factors for Bloodstream Infections Due to Acinetobacter spp.: A Prospective Case-Control Study

• DOI: 10.5152/kd.2015.21
• Publication Date: 2015-12-16T07:11:58Z
• Authors: Mehmet Ucar; Murat Kutlu; Ilknur Kaleli
• Keywords: demography; invasive procedure; 610; Bacteremia; bloodstream infection; parenteral nutrition; high risk patient; 01 natural sciences; Article; Turkey (republic); 03 medical and health sciences; 0302 clinical medicine; 616; beta lactamase inhibitor; antibiotic therapy; antifungal agent; controlled study; human; 0101 mathematics; beta lactam antibiotic; teicoplanin; clinical article; nonhuman; treatment duration; Acinetobacter; disease association; carbapenem derivative; case control study; Parenteral nutrition; 3. Good health; univariate analysis; hospital patient; multivariate analysis; risk factor; Teicoplanin; hospitalization; prospective study

Objective: The aim of this prospective case control study was to describe the risk factors for bacteremia due to Acinetobacter species among hospitalized patients. Methods: The study was conducted prospectively from July 2012 to January 2014, and one case group and two control groups were created. Case group comprising patients with Acinetobacter bacteremia and control group 1 comprising patients with bacteremia due to other agents and control group 2 comprising non-bacteremic patients were compared in terms of demographic characteristics, underlying diseases, invasive procedures, and antibiotic use. Results: The study group (n=23) and control groups (n=46) were compared with univariate analysis and significant risk factors for Acinetobacter bacteremia were as follows: total parenteral nutrition, chemotherapy, use of broad spectrum antibiotics including ß-lactam and ß-lactamase inhibitors, carbapenems, teicoplanin, and antifungals (p<0.05). The duration of hospitalization was longer in case group (p=0.005). In multivariate analysis, factors independently associated with an increased risk of Acinetobacter spp. bacteremia included total parenteral nutrition (odds ratio, OR 5.13; confidence interval 95%, CI 95%, 1.41-18.57; p=0.013), use of a ß-lactam/ß-lactamase inhibitor (OR 7.67; CI 95% 1.67- 35.25; p=0.009), and use of teicoplanin (OR 4.11; CI 95% 1.09- 15.46; p=0.036). Conclusions: The definition of risk factors for Acinetobacter spp. bacteremia may help with the management of patients and infection control precautions by early prediction of the infection. © 2015, AVES Ibrahim Kara. All rights reserved.