Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis
To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field...
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| Veröffentlicht in: | Clinical infectious diseases 1995-04, Vol.20 (4), p.790-796 |
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| creator | Lortholary, Olivier Fagon, Jean-Yves Hoi, Annie Buu Slama, Michel A. Pierre, Josiane Giral, Philippe Rosenzweig, Rachel Gutmann, Laurent Safar, Michel Acar, Jacques |
| description | To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A, baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11–3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001). |
| doi_str_mv | 10.1093/clinids/20.4.790 |
| format | Article |
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Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A, baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11–3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001).</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/clinids/20.4.790</identifier><identifier>PMID: 7795075</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Acinetobacter ; Acinetobacter - drug effects ; Acinetobacter baumannii ; Acinetobacter calcoaceticus ; Acinetobacter Infections - epidemiology ; Acinetobacter Infections - microbiology ; Aged ; Aged, 80 and over ; APACHE ; Bacterial diseases ; Biological and medical sciences ; Case-Control Studies ; Clinical Articles ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Diseases ; Drug Resistance, Multiple ; Female ; Human bacterial diseases ; Humans ; Infections ; Infectious diseases ; Intensive care units ; Length of stay ; Logistic Models ; Logistic regression ; Male ; Medical sciences ; Microbial colonization ; Microbial Sensitivity Tests ; Middle Aged ; Miscellaneous ; Mortality ; Predisposing factors ; Prognosis ; Prospective Studies ; Risk Factors</subject><ispartof>Clinical infectious diseases, 1995-04, Vol.20 (4), p.790-796</ispartof><rights>Copyright 1995 The University of Chicago</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-f70d9031be85adb596c372b8bdb03f710a9f70ab27482f7d5e115761ba0490503</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4458438$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4458438$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27903,27904,57995,58228</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3494620$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7795075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lortholary, Olivier</creatorcontrib><creatorcontrib>Fagon, Jean-Yves</creatorcontrib><creatorcontrib>Hoi, Annie Buu</creatorcontrib><creatorcontrib>Slama, Michel A.</creatorcontrib><creatorcontrib>Pierre, Josiane</creatorcontrib><creatorcontrib>Giral, Philippe</creatorcontrib><creatorcontrib>Rosenzweig, Rachel</creatorcontrib><creatorcontrib>Gutmann, Laurent</creatorcontrib><creatorcontrib>Safar, Michel</creatorcontrib><creatorcontrib>Acar, Jacques</creatorcontrib><title>Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A, baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11–3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001).</description><subject>Acinetobacter</subject><subject>Acinetobacter - drug effects</subject><subject>Acinetobacter baumannii</subject><subject>Acinetobacter calcoaceticus</subject><subject>Acinetobacter Infections - epidemiology</subject><subject>Acinetobacter Infections - microbiology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>APACHE</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Clinical Articles</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Diseases</subject><subject>Drug Resistance, Multiple</subject><subject>Female</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Intensive care units</subject><subject>Length of stay</subject><subject>Logistic Models</subject><subject>Logistic regression</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbial colonization</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>Predisposing factors</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9rFDEYhoMotVbvHhTmIN5m-2WSTCbeSrGusOriL0SEkGQyknYmafPNgP73puywV3NJyPN8L-ENIc8pbCgodu7GEEOP5w1s-EYqeEBOqWCyboWiD8sZRFfzjnWPyRPEawBKOxAn5ERKJUCKU_LrY8Lk0hTMWF24uyVgmEOKVRqqD8s4h-wx4GziXGiIfk7WuNnnypplMjGG8Kb6HPCmuirXKWNlYl_tc_odU5l7Sh4NZkT_bN3PyLert18vt_Xu07v3lxe72nGp5nqQ0Ctg1PpOmN4K1TomG9vZ3gIbJAWjimJsI3nXDLIXnlIhW2oNcAUC2Bl5fci9zelu8TjrKaDz42iiTwtqKRlXrKz_iVQCcKZoEeEgupwQsx_0bQ6TyX81BX3fvF6b1w1orkvzZeTlmr3YyffHgbXqwl-t3KAz45BNdAGPWnkhb5v7mBcH7RpLoUfMueg46wquD7j8iv9zxCbf6FYyKfT2x0-9b9iOff-y1Xv2DwPzppU</recordid><startdate>19950401</startdate><enddate>19950401</enddate><creator>Lortholary, Olivier</creator><creator>Fagon, Jean-Yves</creator><creator>Hoi, Annie Buu</creator><creator>Slama, Michel A.</creator><creator>Pierre, Josiane</creator><creator>Giral, Philippe</creator><creator>Rosenzweig, Rachel</creator><creator>Gutmann, Laurent</creator><creator>Safar, Michel</creator><creator>Acar, Jacques</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19950401</creationdate><title>Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis</title><author>Lortholary, Olivier ; Fagon, Jean-Yves ; Hoi, Annie Buu ; Slama, Michel A. ; Pierre, Josiane ; Giral, Philippe ; Rosenzweig, Rachel ; Gutmann, Laurent ; Safar, Michel ; Acar, Jacques</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-f70d9031be85adb596c372b8bdb03f710a9f70ab27482f7d5e115761ba0490503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Acinetobacter</topic><topic>Acinetobacter - drug effects</topic><topic>Acinetobacter baumannii</topic><topic>Acinetobacter calcoaceticus</topic><topic>Acinetobacter Infections - epidemiology</topic><topic>Acinetobacter Infections - microbiology</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>APACHE</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Clinical Articles</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Diseases</topic><topic>Drug Resistance, Multiple</topic><topic>Female</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Intensive care units</topic><topic>Length of stay</topic><topic>Logistic Models</topic><topic>Logistic regression</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbial colonization</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>Predisposing factors</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lortholary, Olivier</creatorcontrib><creatorcontrib>Fagon, Jean-Yves</creatorcontrib><creatorcontrib>Hoi, Annie Buu</creatorcontrib><creatorcontrib>Slama, Michel A.</creatorcontrib><creatorcontrib>Pierre, Josiane</creatorcontrib><creatorcontrib>Giral, Philippe</creatorcontrib><creatorcontrib>Rosenzweig, Rachel</creatorcontrib><creatorcontrib>Gutmann, Laurent</creatorcontrib><creatorcontrib>Safar, Michel</creatorcontrib><creatorcontrib>Acar, Jacques</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lortholary, Olivier</au><au>Fagon, Jean-Yves</au><au>Hoi, Annie Buu</au><au>Slama, Michel A.</au><au>Pierre, Josiane</au><au>Giral, Philippe</au><au>Rosenzweig, Rachel</au><au>Gutmann, Laurent</au><au>Safar, Michel</au><au>Acar, Jacques</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>1995-04-01</date><risdate>1995</risdate><volume>20</volume><issue>4</issue><spage>790</spage><epage>796</epage><pages>790-796</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>To identify risk factors for and prognostic indicators of the nosocomial acquisition of multiresistant Acinetobacter baumannii in an intensive care unit, we prospectively studied 40 patients: 13 who were infected with this organism and 27 who were colonized. Isolates were identified by pulsed-field gel electrophoresis; the infected/colonized patients were compared with 348 noninfected, noncolonized patients by logistic regression analysis and with matched historical controls in a cohort study. The severity of illness (evaluated by the APACHE II score; P < .05) and previous infection (P < .001) were retained as independent risk factors for acquiring A, baumannii. Logistic regression analysis selected a high APACHE II score (P < .01) and the acquisition of A. baumannii (P < .01) as factors independently associated with death. The acquisition of A. baumannii was associated not only with high mortality but also with a length of stay on the intensive care unit in excess of that due to the underlying disease alone; specifically, the attributable mortality was 25%, with a risk ratio for death of 2.0 (95% confidence interval, 1.11–3.62), and the duration of stay for infected/colonized patients was 10.3 days longer than that for controls (P < .001).</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>7795075</pmid><doi>10.1093/clinids/20.4.790</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 1995-04, Vol.20 (4), p.790-796 |
| issn | 1058-4838 1537-6591 |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals Digital Archive Legacy; Jstor Complete Legacy |
| subjects | Acinetobacter Acinetobacter - drug effects Acinetobacter baumannii Acinetobacter calcoaceticus Acinetobacter Infections - epidemiology Acinetobacter Infections - microbiology Aged Aged, 80 and over APACHE Bacterial diseases Biological and medical sciences Case-Control Studies Clinical Articles Cross Infection - epidemiology Cross Infection - microbiology Diseases Drug Resistance, Multiple Female Human bacterial diseases Humans Infections Infectious diseases Intensive care units Length of stay Logistic Models Logistic regression Male Medical sciences Microbial colonization Microbial Sensitivity Tests Middle Aged Miscellaneous Mortality Predisposing factors Prognosis Prospective Studies Risk Factors |
| title | Nosocomial Acquisition of Multiresistant Acinetobacter baumannii: Risk Factors and Prognosis |
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