Acinetobacter-- serious danger for burn patients

A retrospective study of infection in burn patients admitted to the Clinic for Burns and Reconstructive Surgery Kosice-Saca in the period 2003 to 2006 confirms the increased trend of Acinetobacter (Acb) strains, as a multi-drug-resistant potential pathogen. Over 270 patients are admitted every year to our burn clinic with serious burn injuries, and 75 (on average) to the ICU. Since 1992 the bacterial strain A. baumannii has been sporadically isolated from the wound swabs of the patients admitted to Intensive Care Units (ICU); in 1999 there was a rapid increase in the number of isolates of A. baumannii with increasing resistance to the usual antimicrobials, without clinical manifestation. In 2003, 11% of all hospitalized patients were colonized with A. baumannii, but in 2004 the figure for patients in ICU was 10%. In 2006, 3 patients developed sepsis, 5 patients had uroinfection, 2 patients had pneumonia, and 7 patients had serious wound infections. Wound colonization was confirmed in 17 patients that year. A. baumanii resistance significantly increased after 2003, before the introduction of effective antibiotics against A. baumannii: Ampicilin/Sulbactam (from 16% to 55%), Gentamycin (72%-90%), and Meropenem (from 0% to 4%). The first multi-drug-resistant Acinetobacter baumannii was recorded in 2006 in 8 patients (11%); two patients died of sepsis. Consequently, intensive surveillance of A. baumannii isolates was initiated. The objectives of this investigation were to define the epidemiology of the outbreak and to determine the risk factors for colonization or infection with A. baumannii.