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Acinetobacter-Associated nosocomial infections in Cumhuriyet University Medical Faculty Research Hospital; Three years’ experience

Year 2017, , 555 - 563, 19.09.2017
https://doi.org/10.7197/223.v39i31705.347454

Abstract

Objective: Nosocomial infections have high mortality and morbidity. Acinetobacter is a Gram-negative bacilli and an important nosocomial pathogen. The number of nosocomial infections caused by antibiotic resistant-Acinetobacter strains has increased in recent years. Monitoring these bacterial infections which are difficult to treat, and antibiotic susceptibility, is very important for the appropriate treatment of patients. In this study, nosocomial infections caused by Acinetobacter in the hospital of Cumhuriyet University Medical Faculty during 2014-2016 were investigated.

Method: Acinetobacter-associated nosocomial infections and their rate of antibiotic resistance in patients hospitalizing in the Cumhuriyet University Medical Faculty Research Hospital between January 2014 and December 2016 were retrospectively investigated. The data of this study are the surveillance data of the infection control committee and were obtained from the 3 years data registered in the infline software.

Results: The rate of infection was 3.81% in the hospital, however, it was 30.9% in the Anesthesiology intensive care unit (ICU). In 2016, the rate of infection was lower in the hospital, whereas, it was higher in the Anesthesiology ICU. The number of Acinetobacter strains as a causative agent in the nosocomial infections were higher in 2016, too.

In 7.16% of the nosocomial infections, Acinetobacter species were detected as the causative agent; Acinetobacter baumannii constituting 94.5%.

Only two cases of colistin resistance were seen. Tigecycline resistance was detected in one strain. Meropenem and imipenem resistance were 91.1% and 93.8% for A. baumannii, respectively. Ventilator-associated pneumonia was the most common nosocomial infection due to Acinetobacter baumannii.

Conclusion: Acinetobacter strains are among the most important nosocomial pathogens in our hospital. At the same time, the antibiotic resistance is increasing among Acinetobacter strains. Regular monitoring of these bacterial infections and in vitro susceptibility profiles of them is necessary to ensure an appropriate empirical treatment of Acinetobacter-mediated nosocomial infections.

References

  • 1. Aşık G. Acinetobacter baumannii Virülansının Açıklanmasında Güncel Yaklaşımlar. Mikrobiyol Bul 2011; 45: 371-80.
  • 2. Akın A, Çoruh AE, Alp E, Canpolat DG. Anestezi Yoğun Bakım Ünitesinde Beş Yıl içerisinde Gelişen Nozokomiyal Enfeksiyonlar ve Antibiyotik Direncinin Değerlendirilmesi. Erciyes Tıp Dergisi (Erciyes Medical Journal) 2011; 33: 7-16.
  • 3. Avcı M, Özgenç O, Kıdak LB, Coşkuner A. Evaluation and Monitoring of Device-Associated Infection Rates in Anesthesiology Intensive Care Unit. Turkiye Klinikleri J Med Sci 2009; 29: 917-21.
  • 4. Alpat SN, Aybey AD, Akşit F, Özgüneş İ, Kiremitçi A, Usluer G. Acinetobacter baumannii klinik izolatlarının tigesiklin ve karbapeneme karşı in vitro duyarlılıkları. Mikrobiyol Bul 2010; 44: 641-5.
  • 5. Balcı M, Bitirgen M, Kandemir B, Türk Arıbaş E, Erayman İ Nozokomiyal Acinetobacter baumannii suşlarının antibiyotik duyarlılığı. ANKEM Derg 2010; 24: 28-33.
  • 6. Gorbich Y, Karpov I, Kretchikova O. Impact of appropriate antimicrobial therapy on survival in patients with Acinetobacter baumannii-associated infections. JMID 2013; 3: 163-8.
  • 7. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: 309-32.
  • 8. Almasaudi SB. Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi Journal of Biological Sciences 2016; http://dx.doi.org/10.1016/j.sjbs.2016.02.009 (article in press).
  • 9. Alıcı Ö, Ağalar C, Öztürk S, Akgün N. Fati̇h Sultan Mehmet Eği̇ti̇m ve Araştırma Hastanesi̇ Yoğun Bakım Üni̇tesi̇nde İnvasi̇v Araç İli̇şki̇li̇ Hastane Enfeksi̇yonları; 4 Yıllık Deneyim. Boğaziçi Tıp Dergisi 2014; 1: 114-8.
  • 10. Karasu D, Yılmaz C, Durmuş G, Özer D, Çağlayan Ü, Karaduman İ, Asan A. Yoğun Bakım Ünitesinde Uzun Süre Tedavi Edilen Kritik Durumdaki Hastalarda Sağlık Bakımıyla İlişkili İnfeksiyonların Değerlendirilmesi. Klimik Dergisi 2016; 29): 72-7.
  • 11. Mahamat A, Bertrand X, Moreau B, Hommel D, Couppie P, Simonnet C, Kallel H, Demar M, Djossou F, Nacher M. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014. Int J Antimicrob Agents 2016; 48: 51-5.
  • 12. Taşova Y, Yaman A, Saltoğlu N, Yılmaz G, Kara O, Dündar İH. Nozokomiyal Acinetobacter İnfeksiyonları. Flora 1999; 4: 170-6.
  • 13. Liu H, Wu YQ, Chen LP, Gao X, Huang HN, Qiu FL, Wu DC. Biofilm-Related Genes: Analyses in Multi-Antibiotic Resistant Acinetobacter Baumannii Isolates From Mainland China. Med Sci Monit 2016 28; 22: 1801-7.
  • 14. Cesur S, Toros GY, Altın N, Koldaş K, Solgun G, Şencan İ. Bir Eğitim ve Araştırma Hastanesinin Yoğun Bakım Ünitelerinde Yatan Hastalardan İzole Edilen Çoklu İlaca Dirençli Acinetobacter baumannii Suşlarının Antibiyotik Duyarlılıkları. Ortadoğu Tıp Dergisi 2016; 8: 59-63.
  • 15. Sahu MK, Siddharth B, Choudhury A, Vishnubhatla S, Singh SP, Menon R, Kapoor PM, Talwar S, Choudhary S, Airan B. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit. Ann Card Anaesth 2016; 19: 281-7.
  • 16. Sohail M, Rashid A, Aslam B, Waseem M, Shahid M, Akram M, Khurshid M, Rasool MH. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management. Rev Soc Bras Med Trop 2016; 49: 300-4.
  • 17. Yurtsever SG, Altıner NN, El S, Çetin FL, Pişmişoğlu E, Uzun S. Hastane infeksiyonu etkeni olarak çeşitli klinik örneklerden izole edilen Acinetobacter baumannii izolatlarının antibiyotik duyarlılıkları. ANKEM Derg 2008; 22: 148-52.
  • 18. Central Asian and Eastern European Surveillance of Antimicrobial Resistance. Annual report 2016. (http://www.euro.who.int/__data/assets/pdf_file/0009/323568/CAESAR-Annual-report-2016.pdf?ua=1).
  • 19. Özdem B, Gürelik FÇ, Çelikbilek N, Balıkçı H, Açıkgöz ZC. Çeşitli Klinik Örneklerden 2007-2010 Yıllarında İzole Edilen Acinetobacter Türlerinin Antibiyotik Direnç Profilleri. Mikrobiyol Bul 2011; 45: 526-34.
  • 20. Coşar M, Tuncer Eİ, Arslan U, Mansur A, Otlu B, Türk Dağı H, Fındık D, Durmaz R. Kan Kültürlerinden Soyutlanan Acinetobacter baumannii Suşlarında PER-1 Tipi Beta Laktamaz Varlığı ve Klonal Yakınlığının Araştırılması. Turkiye Klinikleri J Med Sci 2013; 33: 389-95.
  • 21. Doruk S, Köseoğlu Hİ, Yenişehirli G, Etikan İ, Sağlam DA, Yılmaz A, Kaya S, Günal Ö. Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study. Turkiye Klinikleri Arch Lung 2016; 17: 15-20.
Year 2017, , 555 - 563, 19.09.2017
https://doi.org/10.7197/223.v39i31705.347454

Abstract

References

  • 1. Aşık G. Acinetobacter baumannii Virülansının Açıklanmasında Güncel Yaklaşımlar. Mikrobiyol Bul 2011; 45: 371-80.
  • 2. Akın A, Çoruh AE, Alp E, Canpolat DG. Anestezi Yoğun Bakım Ünitesinde Beş Yıl içerisinde Gelişen Nozokomiyal Enfeksiyonlar ve Antibiyotik Direncinin Değerlendirilmesi. Erciyes Tıp Dergisi (Erciyes Medical Journal) 2011; 33: 7-16.
  • 3. Avcı M, Özgenç O, Kıdak LB, Coşkuner A. Evaluation and Monitoring of Device-Associated Infection Rates in Anesthesiology Intensive Care Unit. Turkiye Klinikleri J Med Sci 2009; 29: 917-21.
  • 4. Alpat SN, Aybey AD, Akşit F, Özgüneş İ, Kiremitçi A, Usluer G. Acinetobacter baumannii klinik izolatlarının tigesiklin ve karbapeneme karşı in vitro duyarlılıkları. Mikrobiyol Bul 2010; 44: 641-5.
  • 5. Balcı M, Bitirgen M, Kandemir B, Türk Arıbaş E, Erayman İ Nozokomiyal Acinetobacter baumannii suşlarının antibiyotik duyarlılığı. ANKEM Derg 2010; 24: 28-33.
  • 6. Gorbich Y, Karpov I, Kretchikova O. Impact of appropriate antimicrobial therapy on survival in patients with Acinetobacter baumannii-associated infections. JMID 2013; 3: 163-8.
  • 7. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: 309-32.
  • 8. Almasaudi SB. Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi Journal of Biological Sciences 2016; http://dx.doi.org/10.1016/j.sjbs.2016.02.009 (article in press).
  • 9. Alıcı Ö, Ağalar C, Öztürk S, Akgün N. Fati̇h Sultan Mehmet Eği̇ti̇m ve Araştırma Hastanesi̇ Yoğun Bakım Üni̇tesi̇nde İnvasi̇v Araç İli̇şki̇li̇ Hastane Enfeksi̇yonları; 4 Yıllık Deneyim. Boğaziçi Tıp Dergisi 2014; 1: 114-8.
  • 10. Karasu D, Yılmaz C, Durmuş G, Özer D, Çağlayan Ü, Karaduman İ, Asan A. Yoğun Bakım Ünitesinde Uzun Süre Tedavi Edilen Kritik Durumdaki Hastalarda Sağlık Bakımıyla İlişkili İnfeksiyonların Değerlendirilmesi. Klimik Dergisi 2016; 29): 72-7.
  • 11. Mahamat A, Bertrand X, Moreau B, Hommel D, Couppie P, Simonnet C, Kallel H, Demar M, Djossou F, Nacher M. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014. Int J Antimicrob Agents 2016; 48: 51-5.
  • 12. Taşova Y, Yaman A, Saltoğlu N, Yılmaz G, Kara O, Dündar İH. Nozokomiyal Acinetobacter İnfeksiyonları. Flora 1999; 4: 170-6.
  • 13. Liu H, Wu YQ, Chen LP, Gao X, Huang HN, Qiu FL, Wu DC. Biofilm-Related Genes: Analyses in Multi-Antibiotic Resistant Acinetobacter Baumannii Isolates From Mainland China. Med Sci Monit 2016 28; 22: 1801-7.
  • 14. Cesur S, Toros GY, Altın N, Koldaş K, Solgun G, Şencan İ. Bir Eğitim ve Araştırma Hastanesinin Yoğun Bakım Ünitelerinde Yatan Hastalardan İzole Edilen Çoklu İlaca Dirençli Acinetobacter baumannii Suşlarının Antibiyotik Duyarlılıkları. Ortadoğu Tıp Dergisi 2016; 8: 59-63.
  • 15. Sahu MK, Siddharth B, Choudhury A, Vishnubhatla S, Singh SP, Menon R, Kapoor PM, Talwar S, Choudhary S, Airan B. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit. Ann Card Anaesth 2016; 19: 281-7.
  • 16. Sohail M, Rashid A, Aslam B, Waseem M, Shahid M, Akram M, Khurshid M, Rasool MH. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management. Rev Soc Bras Med Trop 2016; 49: 300-4.
  • 17. Yurtsever SG, Altıner NN, El S, Çetin FL, Pişmişoğlu E, Uzun S. Hastane infeksiyonu etkeni olarak çeşitli klinik örneklerden izole edilen Acinetobacter baumannii izolatlarının antibiyotik duyarlılıkları. ANKEM Derg 2008; 22: 148-52.
  • 18. Central Asian and Eastern European Surveillance of Antimicrobial Resistance. Annual report 2016. (http://www.euro.who.int/__data/assets/pdf_file/0009/323568/CAESAR-Annual-report-2016.pdf?ua=1).
  • 19. Özdem B, Gürelik FÇ, Çelikbilek N, Balıkçı H, Açıkgöz ZC. Çeşitli Klinik Örneklerden 2007-2010 Yıllarında İzole Edilen Acinetobacter Türlerinin Antibiyotik Direnç Profilleri. Mikrobiyol Bul 2011; 45: 526-34.
  • 20. Coşar M, Tuncer Eİ, Arslan U, Mansur A, Otlu B, Türk Dağı H, Fındık D, Durmaz R. Kan Kültürlerinden Soyutlanan Acinetobacter baumannii Suşlarında PER-1 Tipi Beta Laktamaz Varlığı ve Klonal Yakınlığının Araştırılması. Turkiye Klinikleri J Med Sci 2013; 33: 389-95.
  • 21. Doruk S, Köseoğlu Hİ, Yenişehirli G, Etikan İ, Sağlam DA, Yılmaz A, Kaya S, Günal Ö. Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study. Turkiye Klinikleri Arch Lung 2016; 17: 15-20.
There are 21 citations in total.

Details

Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Aynur Engin

Publication Date September 19, 2017
Acceptance Date June 8, 2017
Published in Issue Year 2017

Cite

AMA Engin A. Acinetobacter-Associated nosocomial infections in Cumhuriyet University Medical Faculty Research Hospital; Three years’ experience. CMJ. September 2017;39(3):555-563. doi:10.7197/223.v39i31705.347454