Frequency of Nosocomial Infections with Antibiotic Resistant Strains of Acinetobacter spp. in ICU Patients

Background and Objective: Acinetobacter spp. a Gram-negative coccobacillus is increasingly reported as important cause of nosocomial infections. Multi-drug resistance (MDR) of Acinetobacter spp., raises concerns over our ability to treat serious infections with these organisms. The aim of this study was to determine the frequency and associated risk factors for infections with MDR Acinetobacter spp. in ICU patients of Shahid Mostafa Khomeini Hospital, Tehran, Iran. Patients and Methods: This descriptive-analytical and cross-sectional study was designed in 3 years period from April 2008 to March 2010 on 130 patients. For bacteriological analysis, sputum, blood, urine and wound specimens were used from patients within > 48 hr after admission. Patient’s clinical and epidemiologic data were collected, from recorded file, and correlated to Acinetobacter spp. infection. The data were analyzed using SPSS16 statistical software, chi-square, and Mann- Whitney test. Results: The frequency of Acinetobacter spp. infection separately by years was 21.5%, 30.8% and 47.7% in 2008, 2009, 2010, respectively. All isolates were resistant to carbnicillin, piperacillin, cefotaxime and cephalotin, 99.2% to ciprofloxacin, cotrimoxazole and chloramphenicol, 97.7% to imipenem, 95.4% to tetracycline and 91.5% to gentamicin. The highest sensitivity was to amikacin 14.6%. Conclusion: Nosocomial infections with Acinetobacter spp. during the three years, was a growing trend, and all isolates were MDR and highest susceptibility was to Amikacin. Most important risk factors were incorrect diagnosis, inappropriate usage, doses, and time of antibiotic therapy, inappropriate formulation of some antibiotics.