[Bacteremia caused by Acinetobacter baumannii among patients in critical care].

Abstract

OBJECTIVE: Determine the severity and the course of Acinetobacter baumannii blood infections (AbBI). METHODS: We carried out a prospective review of all Acinetobacter baumannii (A. baumannii) isolated from the Intensive Care Unit (ICU) of a medical facility. RESULTS: During the study period, 46 patients were identified with AbBI. The rate of AbBI was 14 per 1,000 admissions. A. baumannii was ICU acquired in 85% of cases studied. The median time frame between ICU admission and acquisition of AbBI was 9 +/- 7 days. 31 patients displayed blood infection (BI) by A. baumannii alone and 15 with polymicrobial BI. The clinical manifestation of the 31 patients with AbBI included the following symptoms: 42% presented with septic shock, 42% had severe sepsis and 16% had sepsis. Two or more episodes of AbBI were observed among 13% of patients. Of A. baumannii isolates, 17% were resistant to imipenem. Patient mortality with AbBI alone was 45% and 40% for polymicrobial BI. Patient mortality for septic shock was 60%, 70% died during the first 72 hrs after AbBI. CONCLUSIONS: AbBI displayed an endemic pattern during the study period. Severe sepsis and septic shock were the most common clinical presentations of AbBI. AbBI are associated with a significant increase in the death rate of patient in the ICU studied.