Risk factors for acquisition and mortality of multidrug-resistant Acinetobacter baumannii bacteremia: A retrospective study from a Chinese hospital

• Published in: Medicine (Baltimore) 2019-03, Vol.98 (13), p.e14937-e14937
• Main Authors: Zhou, Hua, Yao, Yake, Zhu, Bingquan, Ren, Danhong, Yang, Qing, Fu, Yiqi, Yu, Yunsong, Zhou, Jianying
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii - drug effects; Acinetobacter baumannii - isolation & purification; Acinetobacter Infections - diagnosis; Acinetobacter Infections - epidemiology; Acinetobacter Infections - microbiology; Acinetobacter Infections - mortality; Aged; Anti-Bacterial Agents - adverse effects; Bacteremia - diagnosis; Bacteremia - microbiology; Bacteremia - mortality; beta-Lactamase Inhibitors - adverse effects; Carbapenems - adverse effects; Catheter-Related Infections - epidemiology; Catheter-Related Infections - mortality; China - epidemiology; Cross Infection - epidemiology; Cross Infection - mortality; Drug Resistance, Multiple, Bacterial - physiology; Female; Hospitals - statistics & numerical data; Humans; Male; Middle Aged; Mortality - trends; Observational Study; Pneumonia - epidemiology; Pneumonia - etiology; Pneumonia - mortality; Retrospective Studies; Risk Factors
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000014937

Bloodstream infection caused by Acinetobacter baumannii has become a major clinical concern, especially multidrug-resistant A baumannii (MDRAB). The aim of this study was to identify the risk factors of nosocomial acquired MDRAB bacteremia and to determine the risk factors related to the mortality of patients with MDRAB bacteremia. Patients with nosocomial acquired A baumannii bacteremia were enrolled between January, 2013 and December, 2017 at the First Affiliated Hospital, School of Medicine, Zhejiang University. Medical records were reviewed, and the clinical and microbial characteristics were collected. Among the 338 patients suffering from A baumannii bacteremia, 274 patients were infected with MDRAB bacteremia. Bacteremia-related mortality was 46.4% for the overall sample; 56.2% for MDRAB bacteremia patients, 4.7% for non-MDRAB bacteremia patients. The identified risk factors for developing MDRAB bacteremia were previous exposure to carbapenems [odds ratio (OR) 5.78, P = .005] and penicillins+β-lactamase inhibitors (OR 4.29, P = .009). Primary bacteremia tended to develop non-MDR bacteremia (OR 0.10, P = .002). The risk factors for MDRAB bacteremia-related mortality were old age (OR 1.02, P = .036), a high Pitt bacteremia score (OR 1.32, P