Acinetobacter infections in a tertiary level intensive care unit in northern India: Epidemiology, clinical profiles and outcomes

Summary Background Nosocomial Acinetobacter infections are an increasing concern in intensive care units (ICU). Objectives To study the demographic and clinical characteristics and the outcomes of ICU patients with Acinetobacter infections. Methods A retrospective, 1-year audit of all Acinetobacter infections diagnosed in ICU patients between January 1 and December 31, 2009. Results Acinetobacter infection occurred in 94 patients (108 episodes). The most common site of infection was the respiratory tract (83 patients, 76.85%), with medical patients being more susceptible than surgical patients to Acinetobacter lung infections ( P  = 0.04), particularly late-onset ventilator-associated pneumonia (VAP) ( P  = 0.04). The majority (63.8%) of infections were acquired in the ICU, and patients with ICU acquired infections were intubated significantly longer than the other patients ( P  = 0.02). Seventy percent of the infections were caused by multidrug-resistant (MDR) strains, and the overall crude mortality rate was over 70%. The most important factors affecting mortality were the duration of intubation ( P  = 0.001) and the inappropriate use of antibiotics ( P  = 0.021) after diagnosis of the infection. Conclusions Acinetobacter infections are highly prevalent in the ICU, with medical patients being more susceptible to lung infections, particularly late-onset VAP. The early and appropriate selection of antibiotics is the most important determinant of survival among these patients.