Factors influencing survival in patients with multidrug-resistant Acinetobacter baumannii infection

Abstract

Multidrug-resistant (MDR) Acinetobacter baumannii (Acb) is a rapidly emerging pathogen in healthcare settings. The aim of this study was to evaluate the predictors of poor outcome in patients with MDR Acb. This is the first report documenting factors influencing survival in patients with MDR Acb in this tertiary hospital. This study is a prospective of the hospital epidemiology database. A total of 73 patients with 84 Acb isolates were obtained between August 2009 and October 2010 in this hospital. In the present study, the 30-day mortality rate was 39.7%. Of 84 Acb isolates, 50 (59%) were MDR, nine (11%) were pan-resistant, and 25 (30%) were non-MDR. The non-MDR isolates were used as the control group. The factors significantly associated with multidrug resistance included previous surgeries, presence of comorbidity (renal disease), use of more than two devices, parenteral nutrition, and inappropriate antimicrobial therapy. Significant predictors of 30-day mortality in the univariate analysis included pneumonia, diabetes mellitus, renal disease, use of more than two devices, and inappropriate antimicrobial therapy administered within two days of the onset of infection. The factors associated with mortality in patients with MDR Acb infection in this study were: age > 60 years, pneumonia, diabetes mellitus, renal disease, use of more than two invasive procedures, and inappropriate antimicrobial therapy. Vigilance is needed to prevent outbreaks of this opportunistic and deadly pathogen.

Risk factors for multidrug‐resistant Gram‐negative bacteria infection in intensive care units: A meta‐analysis

“…Seventeen studies (Alexiou et al, 2012;Costa, Atta, & Silva, 2015;Fang, Chen, & Zhou, 2016;Katsaragakis et al, 2008;Liu et al, 2015;Lye et al, 2012;Marcos et al, 2011;Michalopoulos et al, 2011;Osthoff, Mcguinness, Wagen, & Eisen, 2015;Patel et al, 2014; Prata-Rocha, Gontijo-Filho, & Melo, 2012;Tsai et al, 2016;Vasudevan, Memon, Mukhopadhyay, Li, & Tambyah, 2015;Vasudevan, Mukhopadhyay, Li, Yuen, & Tambyah, 2014;Venkatachalam et al, 2014;Young, Sabel, & Price, 2007;Zhong et al, 2012) reported the correlation of gender and MDR-GNB infection ( Figure 2). The random effect model was used to pool results (I 2 = 75.4%, P < 0.001).…”

“…Five studies (Nseir et al, 2011;Prata-Rocha et al, 2012;Tsai et al, 2016;Vasudevan et al, 2014;Young et al, 2007) reported the association of central venous catheterisation and MDR-GNB infection ( Figure 4). The fixed effects model was used due to lack of heterogeneity in the meta-analysis (I 2 = 0%, P>0.10).…”

Copper Resistance of the Emerging Pathogen Acinetobacter baumannii

“…Typically, A. baumannii causes serious disease only in immunocompromised individuals. However, the lack of a suitable treatment against antibiotic-resistant strains can lead to more severe disease and higher mortality (2)(3)(4). Because of the high prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains, the CDC has classified A. baumannii as a "serious" threat (5).…”

“…Worldwide, XDR and PDR strains limit the treatment options for physicians, which can lead to empirical therapy and complications. Not surprisingly, the mortality rate of infection correlates with the level of drug resistance of the infecting strain and whether or not the patient was given appropriate antimicrobial therapy (2)(3)(4). The extensive drug resistance in A. baumannii and other "superbugs" has prompted calls for more atypical antibacterial approaches that take into account the present resistance to most classes of antibiotics.…”

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 .…”