Abstract
Background:Infections caused by Acinetobacter species and Pseudomonas species, especially multidrug-resistant (MDR) strains pose a serious management challenge with a public health threat.Materials and Methods:A hospital-based retrospective study of patients who were infected with Acinetobacter spp or Pseudomonas aeruginosa was carried out at Manipal Teaching Hospital from 2014 to 2016.Results:A total of 170 cases of infections with Acinetobacter spp. and 313 cases with Pseudomonas aeruginosa were studied. The rate of nosocomial infections was higher than non-nosocomial infections. ICU was found as the major hub for both the organisms; (53.5% of cases due to Acinetobacter spp. and 39.6% due to Pseudomonas aeruginosa). Most isolates were of respiratory tract origin (Acinetobacter 74.7% and Pseudomonas aeruginosa 65.8%). Percentage resistance of Acinetobacter spp. towards polymyxin B was found to be quite low (18.8%). Similarly, resistance rates of Pseudomonas aeruginosa against amikacin were also found to be low, i.e., 17.4%. A higher prevalence of multidrug resistance was seen among Acinetobacter spp than among Pseudomonas aeruginosa (75.9% vs. 60.1%). The hospital stay was longer for patients infected with MDR isolate (p=0.001 for Acinetobacter spp. and p=0.003 for Pseudomonas aeruginosa). The mortality rate was higher in infections due to Acinetobacter spp (15.9%) as compared to Pseudomonas aeruginosa (8.3%).Conclusion:This study reveals that infections caused by Acinetobacter species and Pseudomonas aeruginosa are associated with prolonged hospital stay and high in-hospital mortality. These emphasize the need for prudent use of antibiotics and aggressive infection control strategies.
Highlights
Acinetobacter and Pseudomonas species are gram-negative bacilli that commonly cause healthcare-associated infection
Isolation of the organisms from various sources A total of 483 cases were studied, of which specimens from 170 cases grew Acinetobacter spp. and those from the remaining 313 cases grew Pseudomonas aeruginosa
This study reveals that infections caused by Acinetobacter species and Pseudomonas aeruginosa are associated with prolonged hospital stay and high in-hospital mortality
Summary
Acinetobacter and Pseudomonas species are gram-negative bacilli that commonly cause healthcare-associated infection. Infections due to multidrug-resistant (MDR) Pseudomonas aeruginosa and Acinetobacter spp. are believed to result in higher mortality, prolonged hospital stay, and higher health care costs as compared to those caused by antibiotic susceptible bacteria. We attempted to determine the outcome of infections caused by MDR Acinetobacter spp. and Pseudomonas aeruginosa on the mortality rates and length of hospital stay of patients that could have direct implications on the health care costs. Conclusion: This study reveals that infections caused by Acinetobacter species and Pseudomonas aeruginosa are associated with prolonged hospital stay and high in-hospital mortality. These emphasize the need for prudent use of antibiotics and aggressive infection control strategies. Keyword: Acinetobacter spp., Pseudomonas aeruginosa, multi-drug resistance, antibiotic susceptibility
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