Association of Acinetobacter Baumannii with invasive procedures in hospitalized patients in Jakarta

Abstract

Introduction:  Acinetobacter baumannii, a multidrug-resistant Gram-negative opportunist has been known among the cause of nosocomial infection. Risk factors of infection related to A. baumannii have been reported elsewhere.  This study aimed to find the association of A. baumannii positive culture and invasive procedures in patients hospitalized in the Intensive Care Unit and Hospital ward in Jakarta.  Methodology:  This study was a retrospective, 1:1 matched case-control study with total sampling method from in-patients in the ICU and the Internal Medicine Wards (IMW) of a Private Hospital, North Jakarta in 2015 - 2018.  Data retrieved were positive culture of A. baumannii. Positive cultures of multi-sensitive bacteria were included as a control group.  Antibiotic susceptibility test was carried out as recommended by Clinical and Laboratory Standards Institute. Results: A total of 88 in-patients were studied, and A. baumannii isolates were identified from 44 patients.  Most of A. baumannii showed resistant to almost all antibiotics tested, except for colistin.  Bivariate analysis showed a significant association of A. baumannii positive culture and the use of ventilator in the ICU (p = 0,039), and with urinary catheters in the IMW (p = 0,022).  Multivariate analysis showed that length of stay also has a significant association to A. baumannii positive culture in the ICU. Conclusion: The use of ventilators and urinary catheters showed a significant association with Acinetobacter baumannii positive culture in patients in the ICU and in the IMW respectively. All of the A. baumannii isolates were susceptible to colistin.