Acinetobacter infections in a tertiary level intensive care unit in northern India: Epidemiology, clinical profiles and outcomes

SummaryBackgroundNosocomial Acinetobacter infections are an increasing concern in intensive care units (ICU).ObjectivesTo study the demographic and clinical characteristics and the outcomes of ICU patients with Acinetobacter infections.MethodsA retrospective, 1-year audit of all Acinetobacter infections diagnosed in ICU patients between January 1 and December 31, 2009.ResultsAcinetobacter infection occurred in 94 patients (108 episodes). The most common site of infection was the respiratory tract (83 patients, 76.85%), with medical patients being more susceptible than surgical patients to Acinetobacter lung infections (P = 0.04), particularly late-onset ventilator-associated pneumonia (VAP) (P = 0.04). The majority (63.8%) of infections were acquired in the ICU, and patients with ICU acquired infections were intubated significantly longer than the other patients (P = 0.02). Seventy percent of the infections were caused by multidrug-resistant (MDR) strains, and the overall crude mortality rate was over 70%. The most important factors affecting mortality were the duration of intubation (P = 0.001) and the inappropriate use of antibiotics (P = 0.021) after diagnosis of the infection.ConclusionsAcinetobacter infections are highly prevalent in the ICU, with medical patients being more susceptible to lung infections, particularly late-onset VAP. The early and appropriate selection of antibiotics is the most important determinant of survival among these patients.

► We retrospectively reviewed all patients infected with Acinetobacter infection. ► Acinetobacter pneumonia infects medical patients more than surgical. ► Multidrug resistant pathogens caused a majority of the ICU acquired infections. ► Inappropriate antibiotic selection was the most important determinant of mortality.