Evaluation of Clinical and Prognostic Factors Associated with Nosocomial Acinetobacter Infections

Acinetobacter species are opportunistic pathogens with increasing relevance in nosocomial infections. Such infections are often extremely difficult to treat because of the widespread resistance of these bacteria to the major groups of antibiotics. Despite the increasing significance and frequency of multiple resistant Acinetobacter infections, many clinicians still lack an appreciation of the potential importance. Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) are increasing through widespread dissemination of the pathogen. The aims of the study were to identify the Acinetobacter species isolated from clinical samples taken from hospitalized patients by a simplified phenotypic identification, to evaluate various risk and clinical factors predisposing to MDR Acinetobacter infections in a hospital setting and investigate the antibiotic sensitivity of these bacteria. Identification, speciation and antibiotyping were performed for the isolates of Acinetobacter recovered from infective samples. Risk factors and clinical characteristics were studied retrospectively. Of 2633 culture positive samples, 186 (7.064%) were found to be due to Acinetobacter. Respiratory and urine samples were significant contributors towards infection with A. baumannii and was most prevalent in the intensive care unit . A. baumannii was the most predominant species with the isolation rate of 74%. Prolong hospital stay, Mechanical ventilation and Intensive Care Units were found to be potential risk factors. Resistance to antibiotics such as ceftazidime, cefepime, piperacillin/tazobactam, ticarcillin/clavulanic acid, fluoroquinolones, amikacin and gentamicin was seen more in the case of Acinetobacter baumannii as compared with other species. High prevalence of MDR acinetobacter spp in a hospital setup where the selective pressure of antibiotics is already high, showing a need for rational use of antimicrobials. Strict infection-control measures may prevent nosocomial infection and reduce mortality. The analysis of risk factors and susceptibility pattern will be useful in understanding epidemiology of this organism in a health care setup.