Risk factors for mortality in Acinetobacter bacteremia

Abstract

and surgical drainage (52.8%), followed by mechanical ventilation (50.9%), and hemodialysis (5.7%). Mean duration of hospital stay before the onset of bacteremia was 15 days. Twenty-one of the 53 (40%) patients were in the ICU at the time of AB onset, and the mean duration of ICU stay before the onset of bacteremia was eight days. Diabetes mellitus (24.5%) was the most common underlying disease, followed by chronic renal failure (17.0%), chronic obstructive pulmonary disease (11.3%), congestive heart failure (CHF) (11.3%), and chronic liver disease (7.5%). Compared with the AB patients who survived, those who died had more A. baumannii complex and A. Iwoffii as the infecting species, increased use of mechanical ventilation, prior use of central venous catheterization, longer duration of hospital and ICU stay before bacteremia onset, CHF as underlying disease, infusion of total parenteral nutrition and septic shock. Statistically significant association was found only with longer duration of hospital stay before bacteremia onset in a multivariate logistic regression model (odds ratio, 1.069; 95% CI, 1.002-1.140; p = 0.042).The mortality rate of AB in this study was 26.4% (14 cases), which is comparable to other studies (17-52%). 4 A recent retrospective study showed that patients with MDR A. baumannii bacteremia had a higher mortality rate and longer hospital stays compared to those with non-MDR AB. 5 Our study revealed that a longer duration of hospital stay before bacteremia onset is the risk factor that leads to increased mortality. Although a retrospective study lowers the reliability of the conclusion that part of the mortality was directly attributable to longer duration of hospital stay, the impact of these issue is undeniable. At present, the rate of development of new drugs against Dear Editor, Acinetobacter (AB) species are non-fermenting aerobic Gram-negative bacteria that have emerged as important nosocomial pathogens 1 and multidrug resistant (MDR) Acinetobacter strains have increased rapidly. 2 Moreover Acinetobacter bacteremia (AB) is associated with high mortality rates that vary from 17-52%. Although studies have been performed to reveal risk factors that affect MDR or pandrug-resistant (PDR) strains, 3 the risk factor of mortality of patients with AB is yet unclear. With this in mind, the present study was undertaken to identify the risk factors associated with the mortality of AB patients.A retrospective cohort study identifying risk factors for mortality in patients with AB between -bed tertiary hospital in Daejeon, South Korea. Demographic, clinical, and laboratory variables were collected. For statistical analyses the SPSS software was used [95% confidence interval (CI), significant p-value < 0.05].Fifty-three adult patients (30 males, 23 females) with AB were included. The mean age of all patients was 63 years. Acinetobacter baumannii complex was the most common isolate (76%), followed by Acinetobacter lwoffii (21%), and Acinetobacter junii (4%). The antibiograms showed all-sensitive suscept...

An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis

“…Peritonitis caused by Gram-negative bacteria is rare, and may result from touch contamination of dialysis system, exit site or tunnel infection, possible inflammatory process in the abdomen, constipation, etc. The organism is especially difficult to treat because of its ability to survive and persist in hospital environment, as well as its resistance to the broad variety of antibiotics [12][13][14] . Gram-negative peritonitis is particularly troublesome and severe resulting mostly in technique failure, catheter removal or even lethal out- come 5,6 .…”