Acinetobacter infections in a tertiary level intensive care unit in northern India: epidemiology, clinical profiles and outcomes

J Infect Public Health. 2012 Apr;5(2):145-52. doi: 10.1016/j.jiph.2011.12.002. Epub 2012 Feb 16.

Abstract

Background: Nosocomial Acinetobacter infections are an increasing concern in intensive care units (ICU).

Objectives: To study the demographic and clinical characteristics and the outcomes of ICU patients with Acinetobacter infections.

Methods: A retrospective, 1-year audit of all Acinetobacter infections diagnosed in ICU patients between January 1 and December 31, 2009.

Results: Acinetobacter infection occurred in 94 patients (108 episodes). The most common site of infection was the respiratory tract (83 patients, 76.85%), with medical patients being more susceptible than surgical patients to Acinetobacter lung infections (P=0.04), particularly late-onset ventilator-associated pneumonia (VAP) (P=0.04). The majority (63.8%) of infections were acquired in the ICU, and patients with ICU acquired infections were intubated significantly longer than the other patients (P=0.02). Seventy percent of the infections were caused by multidrug-resistant (MDR) strains, and the overall crude mortality rate was over 70%. The most important factors affecting mortality were the duration of intubation (P=0.001) and the inappropriate use of antibiotics (P=0.021) after diagnosis of the infection.

Conclusions: Acinetobacter infections are highly prevalent in the ICU, with medical patients being more susceptible to lung infections, particularly late-onset VAP. The early and appropriate selection of antibiotics is the most important determinant of survival among these patients.

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / epidemiology*
  • Acinetobacter Infections / mortality*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / mortality*
  • Female
  • Humans
  • India / epidemiology
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents