Risk factors of Acinetobacter baumannii infection among patients in the intensive care unit of a tertiary hospital in Cebu City

Title : Risk factors of Acinetobacter baumannii infection among patients in the intensive care unit of a tertiary hospital in Cebu City

Abstract:

Background: Acinetobacter baumannii is a multidrug-resistant pathogen causing severe ICU-acquired infections with high morbidity and mortality. Identifying local risk factors is essential for targeted infection prevention and control.

Objective: To identify clinical and procedural risk factors associated with A. baumannii infection among ICU patients in a tertiary hospital in Cebu City.

Methods: A retrospective unmatched case-control study reviewed 196 ICU patient records from January 2021 to December 2023. Cases had culture-confirmed A. baumannii infection; controls had no isolation. Data included demographics, comorbidities, APACHE II scores, ICU and hospital stay duration, surgical procedures, invasive device use, and prior antibiotic exposure. Associations were analyzed using chi-square tests, t-tests, and multivariable logistic regression.

Results: Among cases, 56.1% were male and 70.4% were >50 years. Comorbidities were present in 57.1%, with 46.3% having multiple comorbidities. Mean APACHE II score was higher in cases (16.6 ± 4.01) than controls (12.5 ± 3.24; p < 0.001). Prolonged ICU stay (>14 days) occurred in 88.8% of cases (p < 0.001); 81.6% underwent surgery (p < 0.001), 74.5% received mechanical ventilation, and 69.4% were transferred from other hospitals (p < 0.001). In-hospital mortality was 78.6% versus 40.8% in controls (p < 0.001).

Multivariable analysis identified APACHE II score as the only independent predictor of infection (OR 0.729; 95% CI: 0.647–0.821; p < 0.001).

Conclusion: Severity of illness (APACHE II score) independently predicts ICU-acquired A. baumannii infection. Prolonged ICU stay, surgery, mechanical ventilation, and inter-facility transfers further increase risk. Early risk stratification, targeted infection control, and antimicrobial stewardship should prioritize high-risk patients to reduce infections and improve outcomes.

Keywords: Acinetobacter baumannii, ICU, APACHE II, risk factors, hospital-acquired Infection.

Biography:

Desiree Sor B. Mejica, R.N., M.D. is a Medical Officer III in the Department of Internal Medicine at Vicente Sotto Memorial Medical Center, Cebu City. She earned her Doctor of Medicine degree from Southwestern University School of Medicine and completed her Post- Graduate Internship at Remedios Trinidad Romualdez Hospital. She previously served as a Medical Officer III at Divine Word Hospital. A graduate of Remedios Trinidad Romualdez Medical Foundation and Asian Development Foundation College, she is a member of the Philippine College of Physicians and Leyte Medical Society, with clinical interests in infectious diseases and internal medicine.