Defining the Risk Factors for the Evolution of Pan-Drug Resistance (PDR) Acinetobacter baumanni Infections in Intensive Care Units

Aim: Acinetobacter baumannii is one important nosocomial pathogens. Acinetobacter infections causes long in hospital stay, mortality and morbidity. The aim of this study is to define the risk factors of PDR A. baumannii caused health care related (HCR) infections. Methods: In the study of Cumhuriyet University Hospital between 01.01.201231.12.2013 is a case-control study was performed retrospectively. 49 PDR A. baumannii caused ventilator associated pneumonia and bacteremia, 71 other bacteria caused ventilator associated pneumonia and bacteremia patients were involved in this study. The PDR A. baumannii infection observed cases and the cases irrelevant to PDR A. baumannii infections are compared in terms of risk factors. Results: As a result of the Univariate Analysis, it was found that DM, traumas, CCI>4, steroid use, hospitalization history in the last 3 months, and antibiotic use in the last 3 months were statistically and significantly higher in the PDR A. baumannii Group. Multivariate analysis was used to determine the risk factors with a p value of 0.1 and below by univariate analysis. In this respect, traumas (OR=93.32, p=0.011), steroid use (OR=21.09, p<0.001) and antibiotic use in the last 3 months. (OR=26.97, p=0.001) were determined as independent risk factors in the development of PDR A. baumannii VAP and bloodstream infection. Conclusions: All risk factors for health care related PDR. Acinetobacter infections were modifiable. The control of these factors may decrease the ratio of PDR A. baumannii. In case of detection of PDR A. baumannii infection in hospitals, control measures should be applicated, hospital staff should be educated and inappropriate antibiotic use should be prohibited.