Risk Factors for Mortality in Patients with Acinetobacter baumannii Bacteremia
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Background: Acinetobacter baumannii, an opportunistic nosocomial pathogen that can cause significant morbidity and mortality,has emerged as a worldwide problem. The aim of this study was to evaluate the risk factors for mortality in patients with A. baumannii bacteremia. Materials and Methods: We retrospectively evaluated 118 patients who had A. baumannii bacteremia between July 2003 and December 2011. The aim of this study was to identify the 30-day mortality in patients with A. baumannii bacteremia and relevant risk factors. Results: The bacteremia-related 30-day mortality rate was 34.1%. Univariate analysis revealed that the risk factors for mortality included malignancy, longer hospital stay before bacteremia, intensive care unit (ICU) stay at the time of bacteremia, mechanical ventilation, use of a central venous catheter, unknown origin of bacteremia, bacteremia due to pneumonia, antimicrobial resistance to carbapenems, and elevated Acute Physiology and Chronic Health Evaluation II and Pitt bacteremia scores. Multivariate logistic regression analysis revealed that resistance to carbapenems (odds ratio [OR]: 4.01, 95% confidence interval [CI]:1.51 to 0.68, P = 0.005), need for mechanical ventilation (OR: 3.97, 95% CI: 1.41 to 11.13, P = 0.005), and presence of malignancy (OR: 4.40, 95% CI: 1.60 to 12.08, P = 0.004) were significantly related to mortality risk. Conclusions: Risk factors such as resistance to carbapenems, mechanical ventilation, and presence of malignancy were found to be associated with high mortality rates in the patients with A. baumannii bacteremia.
Abstract
Background: Acinetobacter baumannii, an opportunistic nosocomial pathogen that can cause significant morbidity and mortality,has emerged as a worldwide problem. The aim of this study was to evaluate the risk factors for mortality in patients with A. baumannii bacteremia. Materials and Methods: We retrospectively evaluated 118 patients who had A. baumannii bacteremia between July 2003 and December 2011. The aim of this study was to identify the 30-day mortality in patients with A. baumannii bacteremia and relevant risk factors. Results: The bacteremia-related 30-day mortality rate was 34.1%. Univariate analysis revealed that the risk factors for mortality included malignancy, longer hospital stay before bacteremia, intensive care unit (ICU) stay at the time of bacteremia, mechanical ventilation, use of a central venous catheter, unknown origin of bacteremia, bacteremia due to pneumonia, antimicrobial resistance to carbapenems, and elevated Acute Physiology and Chronic Health Evaluation II and Pitt bacteremia scores. Multivariate logistic regression analysis revealed that resistance to carbapenems (odds ratio [OR]: 4.01, 95% confidence interval [CI]:1.51 to 0.68, P = 0.005), need for mechanical ventilation (OR: 3.97, 95% CI: 1.41 to 11.13, P = 0.005), and presence of malignancy (OR: 4.40, 95% CI: 1.60 to 12.08, P = 0.004) were significantly related to mortality risk. Conclusions: Risk factors such as resistance to carbapenems, mechanical ventilation, and presence of malignancy were found to be associated with high mortality rates in the patients with A. baumannii bacteremia.
참고문헌 (16)
- 전민혁, "전국병원감염감시체계 중환자실 부문 결과: 2010년 7월부터 2011년 6월", 병원감염관리, 17(1), pp.28~39 (2012), 대한병원감염관리학회[DOI]
- Blot S, "Nosocomial bacteremiainvolving Acinetobacter baumannii in critically ill patients:a matched cohort study", Intensive Care Med, 29, pp.471~475 (2003)
- Maragakis LL, "Acinetobacter baumannii: epidemiology,antimicrobial resistance, and treatment options", Clin Infect Dis, 46, pp.1254~1263 (2008)
- Tseng YC, "Prognosis of adult patients with bacteremia caused by extensivelyresistant Acinetobacter baumannii", Diagn MicrobiolInfect Dis, 59, pp.181~190 (2007)
- 김송이, "Risk Factors for Occurrence and 30-Day Mortality for Carbapenem-Resistant Acinetobacter baumannii Bacteremia in an Intensive Care Unit", Journal of Korean Medical Science, 27(8), pp.939~947 (2012), 대한의학회
- Cisneros JM, "Bacteremiadue to Acinetobacter baumannii: epidemiology, clinicalfindings, and prognostic features", Clin Infect Dis, 22, pp.1026~1032 (1996)
- Wareham DW, "Bloodstream infection due to Acinetobacterspp: epidemiology, risk factors and impact of multidrugresistance", Eur J Cl in Microbiol Infect Dis, 27, pp.607~612 (2008)
- 김윤정, "Risk Factors for Mortality in Patients with Carbapenem-Resistant Acinetobacter baumannii Bacteremia: Impact of Appropriate Antimicrobial Therapy", Journal of Korean Medical Science, 27(5), pp.471~475 (2012), 대한의학회
- Sheng WH, "A multicenter study of risk factors and outcomeof hospitalized patients with infections due to carbapenem-resistant Acinetobacter baumannii", Int J InfectDis, 14, pp.e764~e769 (2010)
- Wikler MA, "Methods for dilution antimicrobial susceptibilitytests for bacteria that grow aerobically; ApprovedStandard" (2008), CLSI
- Garner JS, "CDC definitions for nosocomial infections, 1988", Am J InfectControl, 16, pp.128~140 (1988)
- Lee NY, "Clinical and economic impact of multidrug resistancein nosocomial Acinetobacter baumannii bacteremia", Infect Control Hosp Epidemiol, 28, pp.713~719 (2007)
- Lee YT, "Impact of appropriate antimicrobial therapy on mortalityassociated with Acinetobacter baumannii bacteremia:relation to severity of infection", Clin Infect Dis, 55, pp.209~215 (2012)
- Choi JY, "Mortality risk factorsof Acinetobacter baumannii bacteraemia", Intern Med J, 35, pp.599~603 (2005)
- Routsi C, "Carbapenem-resistant versus carbapenem-susceptibleAcinetobacter baumannii bacteremia in a Greek intensive care unit : risk factors, clinical features andoutcomes", Infection, 38, pp.173~180 (2010)
- Cisneros JM, "Nosocomial bacteremiadue to Acinetobacter baumannii: epidemiology, clinicalfeatures and treatment", Clin Microbiol Infect, 8, pp.687~693 (2002)