Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Frontiers in Cellular and Infection Microbiology

Irani, Jihad¹  Azar, Eid²  Ballouz, Tala²  Afif, Claude²  Nasreddine, Rakan²  Aridi, Jad²  Lakis, Chantal³ 

[1] Department of Family Medicine, Saint George Hospital University Medical Center and University of Balamand, Beirut, Lebanon;Department of Infectious Diseases, Saint George Hospital University Medical Center and University of Balamand, Beirut, Lebanon;Faculty of Medicine, University of Balamand, Beirut, Lebanon

关键词: Acinetobacter baumannii;    Extensive drug resistance;    Bacteremia;    Sepsis;    Risk factors;    Outcome;   

DOI  :  10.3389/fcimb.2017.00156

学科分类：生物科学（综合）

来源: Frontiers

【 摘 要 】

Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients. Univariate analysis showed that prior exposure to high dose steroids, diabetes mellitus, mechanical ventilation, prior use of colistin and tigecycline, presence of septic shock and critical care unit stay were associated with a poor outcome. High dose steroids and presence of septic shock were significant on multivariate analysis. Crude mortality rate was 63.5%. 70.3% of the deaths were attributed to the bacteremia. On acquisition, thirty-nine patients had septicemia. Despite high index of suspicion and initiation of colistin and/or tigecycline in 18/39 patients, a grim outcome could not be averted and thirty-seven patients died within 2.16 days. Seven patients had transient benign bacteremia; three of which were treated with removal of the line. The remaining four did not receive any antibiotics due to withdrawal of care and died within 26.25 days of acquiring the bacteremia, with no signs of persistent infection on follow up. A prolonged hospital stay is frequently associated with loss of functionality, and steroid and antibiotic exposure. These factors seem to impact the mortality of AB bacteremia, a disease with high mortality rate and limited therapeutic options.

【 授权许可】

CC BY