Prediction models to identify hospitalized patients at risk of being colonized or infected with multidrug-resistant Acinetobacter baumannii calcoaceticus complex

Evelina Tacconelli, Maria Adriana Cataldo, Gennaro De Pascale, Daniela Manno, Teresa Spanu, Andrea Cambieri, Massimo Antonelli, Maurizio Sanguinetti, Giovanni Fadda, Roberto Cauda

Research output: Contribution to journalArticle

Abstract

Background: The multidrug-resistant (MDR) Acinetobacter baumannii calcoaceticus complex (Abc) has emerged as an important cause of nosocomial infections. The aims of the study were to evaluate risk factors for MDR-Abc in intensive care units (ICUs) as well as in medical and surgical wards, to define the likelihood ratios (LRs) of risk factors and to determine if risk factors differ depending on whether colonization or infections are considered. Methods: Two prospective matched case-control studies were performed. MDR- Abc was defined as a strain resistant to four or more classes of antibiotics. The two case groups included patients with MDR-Abc infections or colonization. Controls were selected among patients not harbouring Abc. Matching criteria were the number of days from admission to MDR-Abc isolation among cases and the duration of hospitalization among controls. Results: Overall, 514 patients were included in the study. One hundred and thirty-seven patients were infected and 120 colonized. A Charlson score >3 and previous methicillin-resistant Staphylococcus aureus isolation and β-lactam use were independent risk factors for colonization and infection. Bedridden status and previous ICU admission were associated with colonization, while the presence of a central venous catheter and surgery were related to infection. The analysis of LRs showed an association between the presence of more than two risk factors and colonization or infection. The highest predicting value was observed for the presence of more than two risk factors and colonization in patients with no history of ICU admission. Conclusions: This study provides novel information that can be used to identify interventions for different stages of the spread of MDR-Abc.

Original languageEnglish
Pages (from-to)1130-1137
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume62
Issue number5
DOIs
Publication statusPublished - Nov 2008

Keywords

  • Antibiotic resistance
  • Likelihood ratio
  • Nosocomial infections

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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