Risk Factors of Hospital-Acquired Infection or Colonization by Pan-Drug Resistant Acinetobacter baumanii in Bangkok Metropolitan Administration Medical College and Vajira Hospital

Abstract

Risk Factors of Hospital-Acquired Infection or Colonization by Pan-Drug Resistant Acinetobacter baumanii in Bangkok Metropolitan Administration Medical College and Vajira Hospital

On-umar             Banpamai                          MD*

Varankana         Munsakul                            MD*

Busaba                 Supawattanabodee          MSc(Biostatistics)**

* Division of Infectious Diseases, Department of Medicine, BMA Medical College and Vajira Hospital

** Clinical Epidemiology Unit, BMA Medical College and Vajira Hospital

Objective: To determine the risk factors of hospital-acquired infection or colonization by pan-drug resistant Acinetobactr baumanii.

Study design: Prospective case-control study.

Subjects: One hundred and sixty patients with Acinetobacter baumannii infection of colonization admitted to BMA Medical College and Vajira Hospital, Bangkok, Thailand at least 48 hours from January to August 2006 were enrolled.

Methods: All subjects were equally divided into two groups:  non pan-drug resistant Acinetobacter baumannii as control group and pan-drug resistant Acinetobacter baumannii as study group. Data were gathered by interview, physical examination and reviewing hospital records.

Main outcome measures: Risk factors of hospital-acquired infection or colonization by pan-drug resistant Acinetobacter baumannii, length of hospital stay and overall mortality rate.

Results: The demographic data were nos different between two groups. Mean age, median of APACHE II score and median of hospital stay before finding Acinetobacter baumannii in the study group were higher than the control group significantly (62.3±18.5 years. vs 51.5±15.4 years, 27 (range 13-36) vs. 12 (range 2-30) and 20 (range 2-98)  vs  7  (1-93) respectively, p-value 0.001). The only two significant risk factors for pan-drug resistantAcinetobacter baumannii in multivariate analysis were hospital stay for more than  7 days before finding Acinetobacter baumannii (OR=8.6, 95%CI  3.2-23)  and serum creatinine more than 1.5 mg/dl (OR=7.0,  95%CI  2.9-17.1).  The length of hospital stay and overall mortality rate in the study group were higher than the control significantly.

Conclusion: Hospital stay for more than 7 days before finding Acinetobacter baumannii and serum creatinine more than 1.5 mg/dl were the significant risk factors for pan-drug resistant Acinetobater baumannii.

Key word: pan-drug resistant Acinetobacter baumannii, risk factors, length of hospital stay, mortality rate

Vajira Med J 2006 ; 50 : 135 - 144