Resumen de Caracterización de un brote de infección por Acinetobacter baumannii en una unidad de cuidado crítico en Bogotá, Colombia

Nancy Yomayusa, Isabel Cristina Suárez, Paula Hernández Rodríguez, Hernando Gaitán, Hernando Altahona, Milciades Ibáñez Pinilla, Marylin Hidalgo, Jaime Moreno, Edilma Torrado

• español

  Objetivo: caracterización de un brote de infección por Aci-netobacter baumannii y determinación de los factores aso-ciados. Diseño: estudio de casos y controles anidado en una co-         horte de pacientes críticos entre octubre de 2003 y marzo de 2004. Criterios de inclusión: haber estado hospitalizado en la unidadde cuidados intensivos en el mismo periodo y ser sometidosa procedimientos invasivos. Se excluyeron los pacientes quefallecieron en las primeras 24 horas de haber ingresado a la    de otras instituciones.Se evaluó edad, sexo, antecedentes de enfermedad crónica,índice de intervención terapéutica (therapeutic index score     system, TISS), tiempo de uso de dispositivos invasivos, tipode nutrición, exposición previa a antibióticos, procedimientoquirúrgico, tiempo de exposición y estancia. La investigaciónepidemiológica de los aislamientos incluyó la tipificación mo-lecular mediante electroforesis en gel de campo pulsado.

• English

  Objective: Epidemiological and molecular characterization of an outbreak infection caused by Acinetobacter baumannii and the determination of the associated factors.Design: Case-control study nested in a cohort of patients hospitalized in the intensive care unit (ICU) between October 2003 and March 2004.Inclusion criteria: patients that had been hospitalized in the ICU during the same period of time and patients who underwent an invasive procedure. Patients who died during the first 24 hours of admission to the ICU or those submitted or referred from another institution were excluded. Age, gender, past medical history of chronic disease, therapeutic index score system (TISS), time of use of invasive devices, type of nutrition support, previous exposure to antibiotics, surgical procedure, time of exposition and length of stay at the ICU were assessed. The epidemiological research of the isolates included molecular typification through pulse-field gel electrophoresis.Results: The isolates of A. baumannii obtained from infected patients and those from the surveillance cultures were resistant to multiple antibiotics. The isolates were found to be genetically related, with a similarity percentage of more than 97%. A significant statistic relationship was foundbetween infections by A. baumannii, with a higher therapeutic intervention score system during the ICU hospitalization (p=0.030), parenteral nutrition support (p=0.030), and exposure duration (p=0.02).Conclusions: Infection by A. baumannii was associated to a higher therapeutic intervention score system, parenteral nutrition support (p=0.030), and exposition duration (p=0.02). A. baumannii isolates were found to be genetically related.