Authors: M Wadl K Heckenbach I Noll S Ziesing W Pfister J Beer S Schubert T Eckmanns
Publish Date: 2010/01/27
Volume: 38, Issue: 1, Pages: 47-51
Abstract
Acinetobacter baumannii can cause severeinfections mainly in critically ill inpatients Treatment iscomplicated by multidrugresistance MDR In Germany todate little is known on the extent of MDR in A baumanniiisolated from inpatients in German hospitals and potentialfactors influencing the emergence of MDRWe retrospectively analysed thedata of A baumannii isolates from the inpatients of fourGerman university hospitals tested for antimicrobial resistancewith the broth dilution method between 2002 and2006 We defined MDR as resistance to three or more classesof recommended drugs After calculating the proportions ofMDR in A baumannii isolates we investigated the associationbetween MDR in A baumannii and year of pathogenisolation hospital ward type specimen and demographicsWe performed descriptive analysis and multivariable logisticregression Additionally proportions of in vitro drug effectivenessagainst multidrugresistant and nonmultidrugresistantA baumannii isolates were determinedMDR was found in 66 of 1190 56A baumannii isolates and increased from 21 in 2002 to79 in 2006 The highest proportions of MDR were foundin hospital A 89 in intensive care units 73 inisolates from blood 76 and in male patients aged60 years or older 66 In multivariable analysis thechance of MDR in A baumannii isolates increased with thesuccessive years of pathogen isolation odds ratio OR 1395 confidence interval CI 11–15 and there was ahigher risk of MDR in A baumannii in intensive care unitsOR 18 95 CI 11–29 The lowest in vitro antibioticresistance was found in meropenem imipenem and ampicillin/sulbactam with 33 37 and 39 for multidrugresistantand 04 1 and 3 in nonmultidrugresistantA baumannii isolates respectivelyThe increase of MDR in A baumannii isolatesfrom 2002 to 2006 in four hospitals suggests that cliniciansin Germany may expect a rising proportion of MDR inA baumannii isolates among inpatients The antimicrobialsusceptibility testing of A baumannii isolates against recommendeddrugs combined with inhouse antimicrobial resistancesurveillance is needed to ensure appropriate treatment
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