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ISSN 2448-8909 (Print)

2016, Number 3

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Med Crit 2016; 30 (3)

Acinetobacter baumannii, an emergent patogen: prospective study in a respiratory intensive care unit

Martínez-Hernández E, Sánchez-Velázquez LD, Rodríguez-Terán G

Language: Spanish
References: 30
Page: 187-191
PDF size: 177.87 Kb.


ABSTRACT

Objective: Describe the incidency, demographics, associated factors, SAPS-III, mortality associated with A. baumannii infection and frequency of sites culture isolation and drug resistance profile.
Design: Prospective cohort.
Setting: Hospital General de Mexico’s Respiratory Intensive Care Unit (UCIR).
Patients: Of 453 patients admitted to the ICU, 446 cases were included, 235 were male (52.7%). Mean age was 47.9 ± 16.7 years.
Interventions: None.
Results: There were 151 isolates of A. baumannii/haemolyticus in 85 patients (19.1%). Mean age was 50.6 ± 17.0 years (20-85 years). Main previous comorbidities were diabetes mellitus, 25 cases (29.4%) and systemic hypertension, 22 cases (25.9%). Main reasons for admission were septic shock in 39 patients (45.9%), acute respiratory failure, 16 patients (18.8%) and coma, 10 patients (11.8%). Mean SAPS-III was 60.8 ± 14.6, predicted mortality 48.3%. Observed mortality at discharge from the ICU and hospital were 51.8% and 61.2%, respectively. Predicted mortality ratio was 1.27. Average ICU and hospital length of stay were 18.4 ± 14.9 and 30.2 ± 22.4 days, respectively. Isolated strains were MDR by definition. Sensitivity was 19% to 26.5% for aztreonam, piperacillin-tazobactam, moxifloxacin, tobramycin, imipenem and gentamicin, in that order, without being greater for any other antimicrobial drug, except tigecycline with 100% of susceptibility.
Conclusions: The isolation of A. baumannii yields a high impact in morbidity and mortality and is directly related to patient severity reflected in higher scores on scales SAPS III predicted mortality and incidence of MODS and, as expected, greater than other patients in the ICU.


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