Impact of carbapenem resistance on clinical and economic outcomes among patients with Acinetobacter baumannii infection in Colombia

Abstract

Acinetobacter baumannii is a major cause of healthcare-associated infection, often affecting critically ill patients. The purpose of the study was to examine the associations of carbapenem resistance with mortality, length of hospital stay and hospital costs among patients infected with A. baumannii in intensive-care units (ICUs) in Colombia. A prospective, multicentre cohort study was conducted among 165 patients with A. baumannii infection admitted to ICUs between April 2006 and April 2010. Patients with carbapenem-resistant A. baumannii had higher risk of 30-day mortality than patients with carbapenem-susceptible A. baumannii in the univariate analysis (unadjusted hazard ratio = 2.12; 95% CI 1.14-3.95; p 0.018). However, carbapenem resistance was not significantly associated with risk of mortality (adjusted hazard ratio = 1.45; 95% CI 0.74-2.87; p 0.28) after adjusting for APACHE II score and other confounding factors. We did not find a significant difference in length of stay in ICU after the onset of infection between the two groups in the multivariate analysis (adjusted mean = 13.1 days versus 10.5 days; p 0.14). The average total cost of hospitalization among patients with carbapenem-resistant A. baumannii was significantly higher than that among patients with carbapenem-susceptible A. baumannii in the multivariate analysis (adjusted cost; US$ 11 359 versus US$ 7049; p <0.001). Carbapenem resistance was not significantly associated with mortality, though we are unable to rule out an increased risk due to the limited sample size. Carbapenem resistance was associated with an additional cost of hospitalization.

Efficacy of Sulbactam and Its Combination with Imipenem, Colistin and Tigecycline in an Experimental Model of Carbapenem-Resistant <b><i>Acinetobacter baumannii</i></b> Sepsis

“…However, carbapenem-resistant isolates have been increasing worldwide [2,12,13,14,15]. In recent years, carbapenem resistance rates were reported to be over 50% [16,17,18,19,20,21], and in our last study it was found to be 92% in intensive care units [18]. Carbapenem-resistant A. baumannii poses a significant threat in hospitals, as therapeutic options are limited.…”

Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis

“…Study characteristics of the 16 included studies are summarized in Tables and . The sample size of studies ranged from 52 to 386.…”

“…Study characteristics of the 16 included studies are summarized in Tables 1 and 2 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The sample size of studies ranged from 52 to 386.…”

Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

“…We found a higher mortality rate in both groups and our study demonstrates that patients with carbapenem-resistant A. baumannii (CRAB) infections have higher mortality than carbapenemsensitive A. baumannii (CSAB) infections, but the difference we found was not as statistically significant as that in the study by Aydemir et al Although Lemos et al reported a significant difference in the mortality rate between patients with MDR isolates and those with multidrug-susceptible isolates. 17,30 Patients with CRAB pneumonia have a higher mortality rate than that from CSAB pneumonia in Zheng et al study. 31 But we found no statistical difference between the two groups.…”