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March 15, 2008European Journal of Cardio-Thoracic Surgery

Preventing strategy of multidrug-resistant Acinetobacter baumanii susceptible only to colistin in cardiac surgical intensive care units

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Authors

AMAikaterini MastorakiEDEvangelia DoukaIKIoannis Kriaras

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Overview

Prospective cohort study reveals low cure rates with colistin and intermittent containment in cardiac surgical intensive care patients, highlighting the need for strict infection control.

Key Points

  • To evaluate the incidence, mortality, and colistin treatment efficacy for multidrug-resistant Acinetobacter baumannii in a cardiac surgical intensive care unit, and assess the impact of augmented infection control measures.
  • Prospective observational cohort study conducted among cardiac surgical patients (N=1,935) from September 1, 2005, to December 31, 2006.
  • Applied a two-scale protocol: Scale I (standard infection control across 16 months) and Scale II (geographic patient isolation and intense environmental surveillance across two separate 3-week periods).
  • Among 151 infected patients, 20 were colonized or infected with A. baumannii susceptible only to colistin, presenting as respiratory tract infections (n=17), catheter-related infections (n=2), and deep surgical site infection (n=1).
  • Clinical cure or improvement occurred in only 4 of 20 patients (20%) treated with colistin despite confirmed in vitro susceptibility.
  • The infection control strategy achieved intermittent pathogen eradication during continuous ICU operations, with over 350 environmental surveillance samples testing negative.

Cite This Study

Mastoraki et al. (2008) studied this question.

synapsesocial.com/papers/6a870db07fdf9298f89eca87https://doi.org/10.1016/j.ejcts.2008.02.012
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