Journal Article

Risk Factors for Nosocomial Bloodstream Infections Due to <i>Acinetobacter baumannii</i>: A Case-Control Study of Adult Burn Patients

Hilmar Wisplinghoff, Walter Perbix and Harald Seifert

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 1, pages 59-66
Published in print January 1999 | ISSN: 1058-4838
Published online January 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515067
Risk Factors for Nosocomial Bloodstream Infections Due to Acinetobacter baumannii: A Case-Control Study of Adult Burn Patients

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Risk factors for Acinetobacter baumannii bloodstream infection (BSI) were studied in patients with severe thermal injury in a burn intensive care unit where A. baumannii was endemic. Of 367 patients hospitalized for severe thermal injury during the study period, 29 patients with nosocomial A. baumannii BSI were identified (attack rate, 7.9%). Cases were compared with 58 matched controls without A. baumannii BSI. The overall mortality rate was 31% among cases and 14% among controls; only two deaths (7%) were considered directly related to A. baumannii BSI. Molecular typing of A. baumannii blood isolates by means of randomly amplified polymorphic DNA analysis and pulsed-field gel electrophoresis revealed the presence of three different strain types. Multivariate analysis showed that female gender (P = .027), total body surface area burn of >50% (P = .016), prior nosocomial colonization with A. baumannii at a distant site (P = .0002), and use of hydrotherapy (P = .037) were independently associated with the acquisition of A. baumannii BSI in burn patients. These data underscore the need for effective infection control measures for this emerging nosocomial problem.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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