Risk Factors for Resistance and Mortality in Patients with Extensively Resistant Acinetobacter Bacteremia in Taleghani Hospital in Tehran, Iran

Abstract

Objectives: This study describes the antibiotic resistance pattern in patients with Acinetobacter bacteremia and investigates the factors leading to extensively drug resistance (XDR) and mortality. Methods: This descriptive analytical study was conducted in patients with Acinetobacter bacteremia between February 2014 and February 2015. The microorganisms were identified with conventional bacteriological methods and then, following the clinical and laboratory standards institute (CLSI) recommendations, susceptibility testing was performed on all isolates. Moreover, we used electronic records to extract the patients’ data and analyzed them using Chi-square test or Fisher’s exact test and T-Test. Results: Among the influencing factors, the severity of clinical symptoms at the time of admission, longer duration of hospitalization especially in the ICU, and use of invasive devices such as ventilator had a significant relationship with the occurrence of resistance and mortality in the patients. In addition, the central venous catheterization and history of drug resistance such as XDR were associated with mortality. Conclusions: Given the increasing prevalence of XDR Acinetobacter strains causing resistant nosocomial infection, especially in immunocompromised patients, it is necessary to reduce the risk factors leading to drug resistance and mortality. Furthermore, early administration of empiric antibiotic therapy can have a good effect on the outcomes.