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

dc.contributor.authorNtusi, Ntobeko B Aen_ZA
dc.contributor.authorBadri, Motasimen_ZA
dc.contributor.authorKhalfey, Hoosainen_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.contributor.authorOliver, Stephenen_ZA
dc.contributor.authorPiercy, Jennaen_ZA
dc.contributor.authorRaine, Richarden_ZA
dc.contributor.authorJoubert, Ivanen_ZA
dc.contributor.authorDheda, Keertanen_ZA
dc.date.accessioned2016-01-11T06:56:09Z
dc.date.available2016-01-11T06:56:09Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationNtusi, 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/11427/16304en_ZA
dc.identifier.chicagocitationNtusi, 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/11427/16304en_ZA
dc.identifier.citationNtusi, 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.0052452en_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
dc.identifier.urihttp://hdl.handle.net/11427/16304
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0052452
dc.identifier.vancouvercitationNtusi 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.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2012 Ntusi et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAcinetobacter infectionsen_ZA
dc.subject.otherAntibioticsen_ZA
dc.subject.otherBlooden_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherIntensive care unitsen_ZA
dc.titleICU-Associated Acinetobacter baumannii Colonisation/Infection in a High HIV-Prevalence Resource-Poor Settingen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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