Acinetobacter infections: a retrospective study to determine in – hospital mortality rate and clinical factors associated with mortality
Date of Award
Master of Medicine (MMed)
Dr. Reena Shah
Prof. Gunturu Revathi
Dr. Jasmit Shah
Internal Medicine (East Africa)
Background: Acinetobacter infections are increasingly being recognized as a cause for significant in – hospital morbidity and mortality worldwide. Increasingly multi – drug resistant strains of Acinetobacter are being isolated, increasing the burden on healthcare resources. Our objectives were to determine the outcomes and clinical factors related to outcomes of Acinetobacter infections at the Aga Khan University Hospital.
Methods: A retrospective study of Acinetobacter infections (from any site) was conducted. Patient records were used to gather relevant clinical information. The collected data was tabulated and analysed for any significant differences in demographic or clinical variables. The Pearson Chi squared test was used for categorical variables and the Student’s t-test was used for continuous variables. Significant factors were entered into a logistic regression model. Survival analysis using Kaplan Meier and log rank tests were performed to assess for significance between the different subgroups.
Results: Between 2010 and 2017, 80 infections were identified (32 VAP, 24 BSI, 13 skin and soft tissue, 9 pneumonia and 2 UTI) from 204 positive cultures. Thirty six (45%) of the infected patients died. The mean length of stay for the entire cohort was 35.5 days. Diabetes was the most common comorbid condition and Carbapenems were the most frequently prescribed antibiotic prior to infection. Sixty nine (86.25 %) of the Acinetobacter isolates were MDR. The Mean SOFA score, presence of a CVC, Mean age and COPD were found to be significantly different between the two survival groups. Using logistic regression models, the mean SOFA score was significantly associated with mortality.
Conclusion: The mortality from Acinetobacter infections at our institution was 45 %. The most common infection was VAPs. The mean SOFA score, age, COPD and CVC were significant factors between the two survival groups, however, only the mean SOFA score was a predictor of death.
Patel, R. (2018). Acinetobacter infections: a retrospective study to determine in – hospital mortality rate and clinical factors associated with mortality (Unpublished master's dissertation). Aga Khan University, East Africa.