Abstract
Acinetobacter is a Gram-negative coccobacillus and one of the most nosocomial infections. Acinetobacter spp resistant strains in the world have created health problems. The aim of this study was to determine the prevalence and associated risk factors for infections with multi drug resistance (MDR) of Acinetobacter spp. in patients admitted to the ICU of Shahid Mostafa Khomeini Hospital, Tehran, Iran, 2008 to 2010. This descriptive-analytical and cross-sectional study was designed on all of the 130 patients with culture positive for Acinetobacter spp. Microbiologic and specific demographic data were extracted from patient’s laboratory and archive file. The data were analyzed by using SPSS16 statistical software and chi-square and Mann-Whitney test. The prevalence of infection with Acinetobacter spp. separately by years was: 21.5, 30.8 and 47.7% in 1386, 1387 and 1388, respectively. 100% isolates were resistance to Carbnicillin, Piperacillin, Cefotaxime and Cephalotin, 99.2% to Ciprofloxacin, Cotrimoxazole and Chloramphenicol, 97.7% to Imipenem, 95.4% to Tetracycline and 91.5% to Gentamicin. Highest percentage sensitivity was to Amikacin 14.6%. Nosocomial infections with Acinetobacter spp. during the three years, was a growing trend and all isolates were MDR and the highest susceptibility was to Amikacin. It seems that the incorrect diagnosis, use of antibiotics for viral infections, inappropriate doses and time of antibiotic therapy (less or more), inappropriate formulation and low quality of some of antibiotics, are the most important cause of MDR. The proper use of antibiotics to prevent MDR bacterial nosocomial infections is recommended. Key words: Acinetobacter spp, intensive care unit (ICU), multi drug resistance (MDR), nosocomial infections.
Highlights
Nosocomial infection refers to infection that developed during hospitalization and not during the incubation period at admission (Akbari et al, 2005)
Previous studies showed that risk factors for nosocomial Acinetobacter spp. infection include: Increased length of hospital stay, surgery, wounds, broad-spectrum antibiotic therapy, parenteral nutrition, intravascular or urinary catheter, hospitalization in the intensive care unit (ICU) or burn unit, intubation and mechanical ventilation and risk
Our study demonstrated the prevalence of hospital infection with Acinetobacter spp. in three years on a growing trend, and all isolates had multiple drug resistance
Summary
Nosocomial infection refers to infection that developed during hospitalization and not during the incubation period at admission (Akbari et al, 2005). It is well known that hospital infection is a health problem of modern societies. The important causes of nosocomial infections are Acinetobacter spp. Acinetobacter spp, are Gram-negative, aerobic, nonmandatory and encapsulated coccobacillus within family Moraxellaceae. Acinetobacter spp are the most common Gram-negative microorganisms are constantly on the levels and health care worker skin (Khosroshahi and Sharifi 2007; www.infectious disease, accessed 2008). Previous studies showed that risk factors for nosocomial Acinetobacter spp. infection include: Increased length of hospital stay, surgery, wounds, broad-spectrum antibiotic therapy, parenteral nutrition, intravascular or urinary catheter, hospitalization in the intensive care unit (ICU) or burn unit, intubation and mechanical ventilation and risk
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