Risk factors for nosocomial rectal colonization with carbapenem-resistant Acinetobacter baumannii in hospital: a matched case–control study
Abstract
During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. A retrospective matched case–control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR 10.15, 95% CI 2.27–45.39; P = 0.002), mechanical ventilation (OR 40.01, 95% CI 4.05–395.1; P = 0.002), urinary catheters (OR 4.9, 95% CI 1.52–16.19; P = 0.008), McCabe score (OR 5.45, 95% CI 1.87–15.89; P = 0.002), length of stay (OR 1.03, 95% CI 1.01–1.05; P = 0.002), carbapenem use (OR 5.39, 95% CI 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a…
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