TITLE:
Risk Factors Associated with MDR and CR Acinetobacter baumannii Carriage among ICU Patients Hospitalized at MOI Teaching and Referral Hospital, Kenya
AUTHORS:
Fred Kipsang, Abednego M. Musyoki, Nelson C. Menza
KEYWORDS:
MDR, Carbapenem Resistant Acinetobacter baumannii, ICU
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.13 No.4,
December
25,
2023
ABSTRACT: Background: Multi-drug resistant and Carbapenem-Resistant Acinetobacter baumannii (CRAB) infections present a significant challenge in
hospital ICU settings worldwide and the threat posed is worse in developing
countries including Kenya. Despite the limited treatment options, there is
inadequate comprehensive data on factors
associated with MDR and CR Acinetobacter baumannii carriage among ICU patients
hospitalized at hospitals. This study therefore aimed to address this gap and
determined risk factors associated with MDR and CR Acinetobacter baumannii carriage among ICU patients hospitalized
at MOI Teaching and Referral Hospital, Kenya. Methods: Through
cross-sectional study design, a total of 132 ICU admitted patients were
purposively enrolled in this study between July 2019 and July 2020. Demographic
and risk factors associated with MDR and CR Acinobacter baumannii were collected using
structured questionnaire. Descriptive statistics and bivalent analysis were
used for data analysis obtained. Level of statistical significance was 95% confidence interval (CI) for all analysis. Results: Bivariable analysis showed that employed participants were 3.4 times more
likely to have A. baumannii compared to the unemployed (cOR = 3.38, 95%, CI: 1.09 - 10.43, p = 0.035).
Patients who were having high BMI were likely to be infected by A. baumannii compared to those who had normal/low BMI (aOR = 11.2, 95%, CI: 3.57 - 21.11, p = 0.004). Those who were aged ≥ 50 years
were 21 times more likely to be carbapenem-resistant Acinetobacter baumannii, COR = 21.0, 95%
CI: 1.83 - 240.52, p = 0.011. Those who stayed in ICU for more than 30 days
were 16 times more likely to be carbapenem-resistant Acinetobacter baumannii compared to those
who had been admitted (COR = 16.0, 95% CI: 1.45 - 176.45, p = 0.019). Conclusion: Increased length of hospital stay, obesity and
marital status were the factors found to be significantly associated with A. baumannii infections among ICU admitted patients. On the
other hand, gender, age, level of education, occupation, referral status and
presence of infection were found to have no significant association with A. baumannii infections among ICU admitted patients. All patients admitted to the intensive care units should be
screened for colonization with A. baumannii, owing to the poor treatment outcomes associated with carriage of this
multidrug resistant pathogen. Proper infection control in the ICU settings should be upheld to mitigate the spread of A. baumannii in the intensive care units.