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Patients with multi\u2010resistant infection, susceptible exclusively to colistin, were compared with those sustaining non\u2010multi\u2010drug resistant infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 411 patients, 52 (12.6%) developed Acinetobacter infection. Their mean age was 66.3 \u00b1 8.4 years and APACHE II 20.4 \u00b1 7.3 (men: 51.9%). Infection sites were: bloodstream (46.2%), respiratory tract (32.7%), central venous catheter (11.5%), surgical site (7.7%), and urinary tract (1.9%). High multi\u2010resistance (44.2%), morbidity (63.4%), and mortality (44.2%) were identified. Colistin was the most effective antibiotic (100% susceptibility), whereas resistance against all other antibiotics was &gt;60%. Previous septic shock (<jats:italic>p<\/jats:italic>= 0.04), previous adult respiratory distress syndrome (ARDS) (<jats:italic>p<\/jats:italic>= 0.01), number of previous antibiotics (<jats:italic>p<\/jats:italic>= 0.01), previous aminoglycoside use (<jats:italic>p<\/jats:italic>= 0.04), and reoperation (<jats:italic>p<\/jats:italic>= 0.01) were risk factors for multi\u2010resistance in univariate analysis. Morbidity in the multi\u2010resistant group was significantly higher than the non\u2010multi\u2010resistant group (82.6% vs. 48.2%,<jats:italic>p<\/jats:italic>= 0.02). Mortality in the multi\u2010resistant group also was higher; however, this difference did not marginally reach statistical significance (60.8% vs. 31.1%,<jats:italic>p<\/jats:italic>= 0.06). Multivariate analysis identified previous septic shock (<jats:italic>p<\/jats:italic>= 0.04; odds ratio (OR), 9.83; 95% confidence interval (CI), 1.003\u201396.29) and reoperation (<jats:italic>p<\/jats:italic>= 0.01; OR, 8.45; 95% CI, 1.52\u201346.85) as independent predictors of multi\u2010resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>Acinetobacter baumannii<\/jats:italic>infections are frequent and associated with high morbidity, mortality, and multi\u2010resistance. Avoidance of unnecessary antibiotics is a high priority, and specific attention should be paid to patients with previous ARDS and, particularly, previous septic shock and reoperation. When such risk factors are identified, colistin may be the only appropriate treatment.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-008-9571-3","type":"journal-article","created":{"date-parts":[[2008,4,11]],"date-time":"2008-04-11T15:50:30Z","timestamp":1207929030000},"page":"1194-1202","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["<i>Acinetobacter baumannii<\/i>Infections in a Surgical Intensive Care Unit: Predictors of Multi\u2010drug Resistance"],"prefix":"10.1002","volume":"32","author":[{"given":"Stilianos","family":"Katsaragakis","sequence":"first","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haridimos","family":"Markogiannakis","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"},{"name":"Aristeidou 239 Street, Kallithea 17673 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos G.","family":"Toutouzas","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Drimousis","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Larentzakis","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni\u2010Maria","family":"Theodoraki","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care Unit, 1st Department of Propaedeutic Surgery Hippokrateion Hospital, Athens Medical School, University of Athens 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,4,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.274.8.639"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010003\u20101788\u2010x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/520193"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20100691.2004.00942.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00015019"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.11.4086-4095.2000"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.1.43\u201048.2006"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792\u2010199511000\u201000004"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469\u20100691.2002.00487.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/ic.1999.v27.a96961"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1101.040001"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20100691.2005.01256.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010005\u20102691\u20104"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1086\/502302"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/22.6.1026"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.9.2.148"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0196\u20106553(88)90053\u20103"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196\u20106553(05)80201\u20109"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000168253.91200.83"},{"key":"e_1_2_6_21_2","first-page":"M100","volume-title":"Performance standards for antimicrobial susceptibility testing; 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