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Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit.

 Ji Ye Jung  ;  Moo Suk Park  ;  Song Ee Kim  ;  Byung Hoon Park  ;  Ji Young Son  ;  Eun Young Kim  ;  Joo Eun Lim  ;  Sang Kook Lee  ;  Sang Hoon Lee  ;  Kyung Jong Lee  ;  Young Ae Kang  ;  Se Kyu Kim  ;  Joon Chang  ;  Young Sam Kim 
 BMC INFECTIOUS DISEASES, Vol.10 : 228, 2010 
Journal Title
Issue Date
Acinetobacter Infections/epidemiology* ; Acinetobacter Infections/microbiology ; Acinetobacter baumannii/drug effects* ; Acinetobacter baumannii/isolation & purification ; Aged ; Bacteremia/epidemiology* ; Bacteremia/microbiology ; Cross Infection/epidemiology* ; Cross Infection/microbiology ; Drug Resistance, Multiple, Bacterial* ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors
BACKGROUND: Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU. METHODS: We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009. RESULTS: Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; P = 0.035, 22.9 vs. 16.8; P < 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; P = 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; P = 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; P = 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia. CONCLUSIONS: Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Byung Hoon(박병훈)
Son, Ji Young(손지영)
Lee, Kyung Jong(이경종)
Lee, Sang Kook(이상국)
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Lim, Ju Eun(임주은)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
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