Risk Factors for Nosocomial Bloodstream Infections Due toAcinetobacter baumannii:

A Case-Control Study of Adult Burn Patients

  • Wisplinghoff, Hilmar
  • Perbix, Walter
  • Seifert, Harald

  • From the Institute of Medical Microbiology and Hygiene, University of Cologne, and the Department of Plastic Surgery, Städtisches Krankenhaus Köln-Merheim, Cologne, Germany

Received 5 May 1998; revised 6 August 1998.

This work was presented in part at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy held on 28 September-1 October 1997 in Toronto (abstract J-202).

Grant support: This work was supported by the Medical Center of the University of Cologne (Köln Fortune no. V99/1996).

Reprints or correspondence: Dr. Harald Seifert, Institute of Medical Microbiology and Hygiene, University of Cologne, Goldenfelsstrasse 19-21, 50935 Cologne, Germany ([email protected]).

Clinical Infectious Diseases 28(1):p 59-66, January 1999. | DOI: 10.1086/515067

Risk factors forAcinetobacter baumanniibloodstream infection (BSI) were studied in patients with severe thermal injury in a burn intensive care unit whereA. baumanniiwas endemic. Of 367 patients hospitalized for severe thermal injury during the study period, 29 patients with nosocomialA. baumanniiBSI were identified (attack rate, 7.9%). Cases were compared with 58 matched controls withoutA. baumanniiBSI. The overall mortality rate was 31% among cases and 14% among controls; only two deaths (7%) were considered directly related toA. baumanniiBSI. Molecular typing ofA. baumanniiblood isolates by means of randomly amplified polymorphic DNA analysis and pulsed-field gel electrophoresis revealed the presence of three different strain types. Multivariate analysis showed that female gender (P= .027), total body surface area burn of >50% (P= .016), prior nosocomial colonization withA. baumanniiat a distant site (P= .0002), and use of hydrotherapy (P= .037) were independently associated with the acquisition ofA. baumanniiBSI in burn patients. These data underscore the need for effective infection control measures for this emerging nosocomial problem.

Copyright © Copyright Oxford University Press 1999.