ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting

 

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dc.contributor.author Ntusi, Ntobeko B A en_ZA
dc.contributor.author Badri, Motasim en_ZA
dc.contributor.author Khalfey, Hoosain en_ZA
dc.contributor.author Whitelaw, Andrew en_ZA
dc.contributor.author Oliver, Stephen en_ZA
dc.contributor.author Piercy, Jenna en_ZA
dc.contributor.author Raine, Richard en_ZA
dc.contributor.author Joubert, Ivan en_ZA
dc.contributor.author Dheda, Keertan en_ZA
dc.date.accessioned 2016-01-11T06:56:09Z
dc.date.available 2016-01-11T06:56:09Z
dc.date.issued 2012 en_ZA
dc.identifier.citation Ntusi, N. B., Badri, M., Khalfey, H., Whitelaw, A., Oliver, S., Piercy, J., ... & Dheda, K. (2012). ICU-associated Acinetobacter baumannii colonisation/infection in a high HIV-prevalence resource-poor setting. PloS one, 7(12), e52452. doi:10.1371/journal.pone.0052452 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16304
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0052452
dc.description.abstract BACKGROUND: There are hardly any data about the incidence, risk factors and outcomes of ICU-associated A.baumannii colonisation/infection in HIV-infected and uninfected persons from resource-poor settings like Africa. METHODS: We reviewed the case records of patients with A.baumannii colonisation/infection admitted into the adult respiratory and surgical ICUs in Cape Town, South Africa, from January 1 to December 31 2008. In contrast to colonisation, infection was defined as isolation of A.baumannii from any biological site in conjunction with a compatible clinical picture warranting treatment with antibiotics effective against A.baumannii . RESULTS: The incidence of A.baumannii colonisation/infection in 268 patients was 15 per 100 person-years, with an in-ICU mortality of 26.5 per 100 person-years. The average length of stay in ICU was 15 days (range 1-150). A.baumannii was most commonly isolated from the respiratory tract followed by the bloodstream. Independent predictors of mortality included older age (p = 0.02), low CD4 count if HIV-infected (p = 0.038), surgical intervention (p = 0.047), co-morbid Gram-negative sepsis (p = 0.01), high APACHE-II score (p = 0.001), multi-organ dysfunction syndrome (p = 0.012), and a positive blood culture for A.baumannii (p = 0.017). Of 21 A.baumannii colonised/infected HIV-positive persons those with clinical AIDS (CD4<200 cells/mm 3 ) had significantly higher in-ICU mortality and were more likely to have a positive blood culture. Conclusion In this resource-poor setting A.baumannii infection in critically ill patients is common and associated with high mortality. HIV co-infected patients with advanced immunosuppression are at higher risk of death. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Acinetobacter infections en_ZA
dc.subject.other Antibiotics en_ZA
dc.subject.other Blood en_ZA
dc.subject.other HIV en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other Adults en_ZA
dc.subject.other Death rates en_ZA
dc.subject.other Intensive care units en_ZA
dc.title ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2012 Ntusi et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Ntusi, N. B. A., Badri, M., Khalfey, H., Whitelaw, A., Oliver, S., Piercy, J., ... Dheda, K. (2012). ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting. <i>PLoS One</i>, http://hdl.handle.net/11427/16304 en_ZA
dc.identifier.chicagocitation Ntusi, Ntobeko B A, Motasim Badri, Hoosain Khalfey, Andrew Whitelaw, Stephen Oliver, Jenna Piercy, Richard Raine, Ivan Joubert, and Keertan Dheda "ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting." <i>PLoS One</i> (2012) http://hdl.handle.net/11427/16304 en_ZA
dc.identifier.vancouvercitation Ntusi NBA, Badri M, Khalfey H, Whitelaw A, Oliver S, Piercy J, et al. ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting. PLoS One. 2012; http://hdl.handle.net/11427/16304. en_ZA
dc.identifier.ris TY - Journal Article AU - Ntusi, Ntobeko B A AU - Badri, Motasim AU - Khalfey, Hoosain AU - Whitelaw, Andrew AU - Oliver, Stephen AU - Piercy, Jenna AU - Raine, Richard AU - Joubert, Ivan AU - Dheda, Keertan AB - BACKGROUND: There are hardly any data about the incidence, risk factors and outcomes of ICU-associated A.baumannii colonisation/infection in HIV-infected and uninfected persons from resource-poor settings like Africa. METHODS: We reviewed the case records of patients with A.baumannii colonisation/infection admitted into the adult respiratory and surgical ICUs in Cape Town, South Africa, from January 1 to December 31 2008. In contrast to colonisation, infection was defined as isolation of A.baumannii from any biological site in conjunction with a compatible clinical picture warranting treatment with antibiotics effective against A.baumannii . RESULTS: The incidence of A.baumannii colonisation/infection in 268 patients was 15 per 100 person-years, with an in-ICU mortality of 26.5 per 100 person-years. The average length of stay in ICU was 15 days (range 1-150). A.baumannii was most commonly isolated from the respiratory tract followed by the bloodstream. Independent predictors of mortality included older age (p = 0.02), low CD4 count if HIV-infected (p = 0.038), surgical intervention (p = 0.047), co-morbid Gram-negative sepsis (p = 0.01), high APACHE-II score (p = 0.001), multi-organ dysfunction syndrome (p = 0.012), and a positive blood culture for A.baumannii (p = 0.017). Of 21 A.baumannii colonised/infected HIV-positive persons those with clinical AIDS (CD4<200 cells/mm 3 ) had significantly higher in-ICU mortality and were more likely to have a positive blood culture. Conclusion In this resource-poor setting A.baumannii infection in critically ill patients is common and associated with high mortality. HIV co-infected patients with advanced immunosuppression are at higher risk of death. DA - 2012 DB - OpenUCT DO - 10.1371/journal.pone.0052452 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting TI - ICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Setting UR - http://hdl.handle.net/11427/16304 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.