A Decade of Nosocomial Acinetobacter

A review of nosocomial infections (NI) from January 1971 to April 1981 was conducted in a university-affiliated hospital to examine NI caused by Acinetobacter and to determine whether a rising trend in rates could be detected. Acinetobacter accounted for 85 of 6115 (1.4%) NI. Sites of infection were respiratory tract (42.2%), blood (17.8%), peritoneum (16.7%), urinary tract (10%), surgical wounds (7.8%), central nervous system (3.3%), and skin or eye (2.2%). All patients who developed NI from Acinetobacter were receiving systemic antimicrobial therapy; 58.8% were in the intensive care unit (ICU). The highest rates of Acinetobacter infection occurred in the early 1970s (2.3%); the lowest occurred from 1978 to 1981 (0.94%), p approximately 0.06. This decrease primarily resulted from two factors: a reduction in cross-infections, probably related to a structural change in the ICU from open-bed ward to single rooms, and the elimination of peritoneal infections traced to contamination of dialysate solution. We conclude that in this institution no rise in the proportion of NI caused by Acinetobacter has occurred over the past decade; if anything, there is a downward trend.