Risk factors for carbapenem-resistant Acinetobacter baumannii infections at a tertiary care hospital in New Caledonia, South Pacific

Abstract In New Caledonia, South Pacific, Acinetobacter baumannii is a nosocomial pathogen. OXA-23 carbapenem-resistant A. baumannii (CRAB) has been ranked third among all multidrug-resistant (MDR) bacteria at the main hospital of Nouméa in New Caledonia (24.8%, 50/202 isolates). In the present stud...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 2010-12, Vol.42 (11-12), p.821-826
Main Authors: Le Hello, Simon, Falcot, Virginie, Lacassin, Flore, Mikulski, Marc, Baumann, Francine
Format: Article
Language:English
Subjects:
Acinetobacter baumannii - drug effects
Acinetobacter baumannii - isolation & purification
Acinetobacter Infections - epidemiology
Acinetobacter Infections - microbiology
Acinetobacter Infections - mortality
Adult
Aged
Anti-Bacterial Agents - pharmacology
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
beta-Lactam Resistance
Biological and medical sciences
Carbapenems - pharmacology
Cross Infection - epidemiology
Cross Infection - microbiology
Cross Infection - mortality
Female
Hospitals
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
New Caledonia - epidemiology
Pharmacology. Drug treatments
Risk Factors
Treatment Outcome
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Summary:Abstract In New Caledonia, South Pacific, Acinetobacter baumannii is a nosocomial pathogen. OXA-23 carbapenem-resistant A. baumannii (CRAB) has been ranked third among all multidrug-resistant (MDR) bacteria at the main hospital of Nouméa in New Caledonia (24.8%, 50/202 isolates). In the present study, risk factors and outcomes for 50 patients with CRAB infection were compared with those of 152 patients infected with other MDR bacteria. Independent risk factors for infection with CRAB were respiratory ward admission (odds ratio 2.8, 95% confidence interval 1.1-7.1) and previous treatment with quinolones, β-lactams and anti-MRSA antibiotics. The 30-day mortality was higher for CRAB infections compared with other MDR infections (14% vs 3.3%, p = 0.006). These findings highlight the importance of knowing specific local characteristics relating to the ecology and patterns of resistance of MDR bacteria so as to avoid the emergence of unexpected pan-resistant bacteria.
ISSN:0036-5548
1651-1980
DOI:10.3109/00365548.2010.496087