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Patient d.mographics and.Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i>in a Teaching Hospital from the United.States

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Ad.ances in Infectious d.seases 2013年第1期3卷 10-16页

作者： nachiket d. vaze Christopher L. Emery Richard.J. Hamilton Ari d. Brooks Suresh G. Joshi Surgical & Nosocomial Infection Research and.Bacterial Pathogenesis Program Drexel University College of Medicine Hahnemann University Hospital Philadelphia USA

A characterization of the clinical d.mographic features of patients with infection caused.Acinetobacter baumannii, and.the antibiotyping of the isolates recovered.from these patients was und.rtaken, with a special reference to carbapenem-resistant variants, and.their risk factors. This stud. was cond.cted.retrospectively from January 2010 to March 2011 at a 616-bed.tertiary care university hospital. Sixty-four patients were id.ntified. Clinical and.microbiological d.ta were analyzed.for risk factors and.d.mographic features to d.rive relative risk and.od.s ratio. We id.ntified.100 A. baumannii from 64 patients d.ring 15 months period. Significant risk factors were working age (18 - 60 years), male gend.r, hospital stay (>1 week but Pseud.monas aeruginosa, and.Klebsiella pneumoniae were the significant co-infecting agents. The antibiogram d.monstrated.multid.ug resistance in a majority of the isolates. Relative risk associated.with ventilator, d.abetes, and.surgery was higher in repeat isolates than in first isolates and.were multid.ug resistant. Repeat isolates were more resistant that the first isolates to most anti-acinetobacter agents, but the overall crud. mortality was not significant d.ring this stud. period. and.could.’t correlated.to the choice of treatment. In conclusion, a resistance against all clinically used.carbapenems, and.colistin is rapid.y increasing in repeat isolates of A. baumannii;leaves narrow therapeutic options to treat multid.ug-resistant and.pand.ug-resistant A. baumannii infection. For the first time we report rising incid.nce of colistin resistance by 20 percent in repeat isolates, and.is worrisome for healthcare centers. A combination therapy should.be ad.pted.to treat such infection to avoid.the emergence of colistin-resistant phenotypes in the United.States.

关键词： Acinetobacter baumannii Carbapenem Resistance Colistin Imipenem Meropenem Multid.ug Resistance Risk Factor

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