Medical and Health Sciences

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https://hdl.handle.net/20.500.11888/18295

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Browsing Medical and Health Sciences by Author "Arjan, Shaden"

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    EPIDEMIOLOGY OF ACINETOBACTER BAUMANNII INFECTIONS AMONG PATIENTS ADMITTED TO THREE INTENSIVE CARE UNITS IN PALESTINE: A RETROSPECTIVE CHART REVIEW STUDY
    (An-Najah National University, 2024-10-30) Arjan, Shaden
    Background: Multidrug-resistant (MDR) strains of Acinetobacter baumannii pose significant treatment challenges. This study aimed to evaluate the sociodemographic and clinical characteristics of patients with A. baumannii infections in medical intensive care units (ICUs) across three hospitals in the West Bank, Palestine. It also sought to determine the prevalence of multidrug-resistant and extensively drug-resistant strains and assess patient survival and mortality rates. Methods: A retrospective cohort design was conducted from 2019 to 2020, spanning a period of two years, and including patients from adult medical ICUs from three hospitals of the north (NICU), the center (CICU), and the south (SICU) of in the West Bank, Palestine. Data on infections acquired during ICU stays or present at admission were analyzed using patient medical records, where sociodemographic, clinical, and treatment-related information, including comorbidities, infection history, diagnostic results, therapies, device usage, and outcomes such as ICU length of stay and mortality, were collected, and prevalence was calculated. Results: The study encompassed 231 patients, with 136 (58.9%) from CICU Hospital, 56 (24.2%) from SICU Hospital, and 36 (16.9%) from NICU Hospital. The median patient age was 63 years. Prevalence rates of A. baumannii infections were 11.5% at CICU Hospital, 6.5% at NICU Hospital, and 5.3% at SICU Hospital, with an overall rate of 8.2%. Of the patients, 46 (19.9%) had infections upon admission, while 185 (80.1%) developed infections during their ICU stay. The isolates included 154 (66.7%) extensively drug-resistant (XDR), 61 (26.4%) multidrug-resistant (MDR), and 16 (6.9%) non-resistant strains. Factors associated with increased mortality included recent ICU admission (2.65 times more likely), heart failure (4.95 times more likely), and central line catheter use (3.46 times more likely). Higher white blood cell counts, lower platelet counts, longer ICU and mechanical ventilation durations, and shorter hospital stays, shorter therapy were linked to survival. Conclusions: This study provides a comprehensive understanding of A. baumannii infections in the medical ICUs, highlighting the critical need for multidisciplinary infection control, especially for critically ill patients with comorbidities. The rise of drug-resistant bacteria underscores the importance of antimicrobial stewardship and infection control. Findings suggest a need for ongoing research and collaboration to address this growing hospital-acquired issue effectively.