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Lee, Y.T., S.C. Kuo, S.P. Yang, Y.T. Lin, and F.C. Tseng et al., 2012. Impact of appropriate antimicrobial therapy on mortality associated with Acinetobacter baumannii bacteremia: relation to severity of infection. Clin Infect Dis., 55 (2): 209-215.

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Article

The Role of APACHE-II Score in Predicting Acinetobacter baumannii Colonization/Infection and Its Antimicrobial Resistance Pattern in Indonesian Teaching Hospital

1Faculty of Medicine, University of Pelita Harapan, Tangerang, Indonesia

2Department of Microbiology, Faculty of Medicine, University of Pelita Harapan, Tangerang, Indonesia

3Intensive Care Unit, Siloam Hospital Lippo Village, Tangerang, Indonesia


American Journal of Infectious Diseases and Microbiology. 2016, Vol. 4 No. 3, 56-60
DOI: 10.12691/ajidm-4-3-2
Copyright © 2016 Science and Education Publishing

Cite this paper:
Ian Huang, Gregoey Joey, Cucunawangsih, Oloan E. Tampubolon. The Role of APACHE-II Score in Predicting Acinetobacter baumannii Colonization/Infection and Its Antimicrobial Resistance Pattern in Indonesian Teaching Hospital. American Journal of Infectious Diseases and Microbiology. 2016; 4(3):56-60. doi: 10.12691/ajidm-4-3-2.

Correspondence to:  Cucunawangsih, Department of Microbiology, Faculty of Medicine, University of Pelita Harapan, Tangerang, Indonesia. Email: cucunawangsih.fk@uph.edu

Abstract

Background: A first precautionary action against Acinetobacter baumannii (A.baumanii) can be conducted by identifying well-established risk factors of colonization/infection of that pathogen, such as underlying severity of illness. There are hardly any studies regarding the role of APACHE-II score in predicting risk of A.baumannii colonization/infection in Indonesia. Materials and Methods: A retrospective, case control investigation was performed with medical and microbiology records of ICU patients in an Indonesian Teaching Hospital from January 2013 to December 2014. Results: There were 39 patients with A.baumannii colonization/infection and 59 patients with non-A.baumannii colonization/infection enrolled in this study. Patients with A.baumannii colonization/infection had a significantly higher APACHE II score than non-Acinetobacter group, 25.7 and 23.1 (p=0.038), respectively. APACHE II score ≥ 23 had 74.4% sensitivity and 50.8 specificity to A.baumannii colonization/infection [odd ratio (OR) 3.00, 95% confidence interval (CI) 1.24-7.24, p=0.013], on the other hand APACHE II ≥ 27 had a 53.8% sensitivity and 78.0% specificity (OR 3.75, 95% CI 1.57-8.95, p=0.002). The highest susceptibility level of antibiotics against A.baumannii in this study was shown by tigecycline (82.1%) and amikacin (84.6%). Conclusions: APACHE-II score was strongly correlated with A.baumannii colonization/infection and a cut-off value of APACHE II score ≥ 23 may be used to depict increased moderate risk of A.baumannii colonization/infection. While the use carbapenem against A. baumannii infection was not recommended, tigecycline and amikacin may be considered as antibiotics of choice in treating A.baumannii infection in our hospital setting.

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