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    RISC FACTORS ASSOCIATED WITH IMIPENEM RESISTANCE IN NOSOCOMIAL ACINETOBACTER BAUMANNII INFECTIONS
    (NOBEL ILAC, 2012) Balci, Mehmet; Bitirgen, Mehmet; Kandemir, Bahar; Aribas, Emel Turk; Erayman, Ibrahim
    Objective: This study was conducted to identify the risk factors associated with imipenem resistance in recently increase with frequency of nosocomial Acinetobacter baumannii infections. Material and Method: In the present study, strains of A. baumannii isolated from various clinical samples obtained from the patients followed at the Meram Faculty of Medicine Hospital of Selcuk University between September 2005 and March 2007 and whose samples were sent to the Department of Clinical Bacteriology and Infectious Disease laboratories were evaluated. Results: The imipenem resistance rate of the 79 patients who were evaluated was 54.5%; risc factors associated with imipenem resistance were determined according to the E-test method. Prolonged hospitalization, previous use of a third generation cephalosporin, carbapenem and glycopeptides, use of any antibiotic for longer than 21 days, presence of a central catheter, tracheostomy and/or intubation, mechanical ventilation, transfusion, administration of total parenteral nutrition, use of an antiacid, hemodialysis or hemofiltration and the presence of pneumonia were shown to be resistance-associated factors by using single variance analysis (p<0.05). Independent risk factors associated with imipenem resistance were determined to be the presence of a central catheter [odds ratio (OR) 4.34; 95% confidence interval (CI) 1.1-17.1; p=0.010], carbapenem use (OR 3.769; 95% CI 1.1-12.7; p=0.000), and period of hospitalization for longer than 21 days (OR 3.787; 95% CI 1.01-14.696; p=0.000) by using multiple variance analysis. Isolation of A. baumannii from the surgical site was associated with imipenem sensitivity (OR 0.176; 95% CI 0.45-0.684; p=0.05). Conclusion: The incidence of imipenem resistant A. baumannii infections increased during the last years especially in critical care units. Imipenem resistant Acinetobacter baumannii infections should be considered and required precautions must be taken in patients who had a history of the usage of central venous catheter and carbapenems and in patients with long hospital stay.