the importance of colonization pressure in multiresistant acinetobacter baumannii acquisition in a greek intensive care unit殖民的重要性压力抗多种抗菌素的鲍曼不动杆菌收购希腊重症监护室.pdfVIP

Arvaniti et al. Critical Care 2012, 16:R102 /content/16/3/R102 RESEARCH Open Access The importance of colonization pressure in multiresistant Acinetobacter baumannii acquisition in a Greek intensive care unit 1* 2 3 4 5 Kostoula Arvaniti , Dimitrios Lathyris , Raymond Ruimy , Anna-Bettina Haidich , Vasiliki Koulourida , Pavlos Nikolaidis6, Dimitrios Matamis1 and Spiros Miyakis7 Abstract Introduction: We investigated the role of colonization pressure on multiresistant Acinetobacter baumannii acquisition and defined patient-related predictors for carriage at admission and acquisition during hospitalization in intensive care unit (ICU) patients. Methods: This was a 12-month, prospective, cohort study of all patients admitted to a single ICU of a tertiary hospital. Screening samples were collected at ICU admission to identify imported carriers, and weekly during hospitalization to identify acquisition. Colonization pressure (carriers’ patient-days × 100/all patients’ patient-days) and the absolute number of carriers were calculated weekly, and the statistical correlation between these parameters and acquisition was explored. Multivariable analysis was performed to identify predictors for A. baumannii carriage at admission and acquisition during hospitalization. A. baumannii isolates were genotyped by repetitive-extragenic-palindromic polymerase chain reaction (PCR; rep-PCR). Results: At ICU admission, 284 patients were screened for carriage. A. baumannii was imported in 16 patients (5.6%), and acquisition occurred in 32 patients (15.7%). Acquisition was significantly correlated to weekly colonization pressure (correlation coefficient, 0.379; P = 0.004) and to the number of carriers