Prognosis of adult patients with bacteremia caused by extensively resistant Acinetobacter baumannii

Tseng, Yeu-Yang; Wang, Jann-Tay; Wu, Fe-Lin Lin; Chen, Yee‐Chun; Chie, Wei‐Chu; Chang, Shan-Chwen

doi:10.1016/j.diagmicrobio.2007.04.024

Cited by 58 publications

(51 citation statements)

References 37 publications

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“…A previous study showed that approximately 30% of patients with bacteremia caused by A. baumannii had hepatobiliary disease (20). Another study reported that one of the conditions associated with community-acquired pneumonia was liver cirrhosis (21).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

et al. 2012

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Objective Acinetobacter baumannii is a worldwide nosocomial pathogen that has become increasingly common over the past few decades, and strains of multidrug-resistant A. baumannii have been increasing. The aim of this study was to assess the clinical characteristics of A. calcoaceticus-A. baumannii complex (Acb complex) strains and to determine the risk factors of this infection. Methods The medical records of 121 patients at Nagasaki University Hospital from whom Acb complex had been isolated between January 2007 and December 2009 were retrospectively reviewed. Patient backgrounds, sensitivity to antibiotics, risk factors for infection, and prognosis were evaluated. Results Lower respiratory isolates accounted for 73% (147 strains) of all 201 isolates. Most of the isolates were sensitive to carbapenems. Of the 121 patients (74 males and 47 females; mean age: 62.1 years), 48 (39.7%) had malignancy and 75 (62.0%) were treated with antibiotics prior to isolation. Thirty-seven of the patients in this study (30.6%) were infected by Acb complex and the most frequent clinical manifestation was pneumonia (18 cases; 48.6%). Approximately 60% of infected patients were treated with β-lactam agent in combination with β-lactamase inhibitors or carbapenems. The mortality rate of infected patients was significantly higher than that of colonized patients (infected: 24.3%, colonized: 6.0%, p<0.05). Risk factors for Acb complex infection include being over 60 years of age, chronic liver disease, and the use of firstgeneration cephalosporins prior to isolation. Conclusion Acb complex was relatively sensitive to antibiotics. The appropriate usage of antibiotics should be continued for the prevention of drug resistance in Acb complex.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

et al. 2012

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“…Invasive therapeutic procedures included usage of a central venous catheter (CVC), arterial catheter, port A catheter, endotracheal tube, nasogastric (NG)/nasoduodenal tube, peripheral venous catheter, thoracentesis, or paracentesis within 7 days prior to acquisition of MRSA (for these who were positive for MRSA) or during the period from 7 days before ICU admission to the time of discharge from the ICU (for those who were negative for MRSA). Recent operation was defined as (i) a simple procedure performed under local anesthesia within 7 days prior to acquisition of MRSA (for those who were positive for MRSA) or during the period from 7 days before ICU admission to the time of discharge from the ICU (for those who were negative for MRSA) or (ii) an operation performed under general anesthesia within 30 days prior to acquisition of MRSA (for those who were positive for MRSA) or during the period from 30 days before ICU admission to the time of discharge from the ICU (for those who were negative for MRSA) (29).…”

Section: Patientsmentioning

confidence: 99%

“…The APACHE II scores were divided into low and high groups, with a cutoff point of 17, as suggested in previous reports (29). Initially, antibiotics were classified into 17 groups: group 1, penicillins without antipseudomonal effects that were not combined with ␤-lactamase inhibitors; group 2, antipseudomonal penicillins; group 3, penicillins combined with ␤-lactamase inhibitors; group 4, narrow-spectrum cephalosporins; group 5, expanded-spectrum cephalosporins; group 6, broad-spectrum cephalosporins without antipseudomonal effects; group 7, broad-spectrum cephalosporins with antipseudomonal effects; group 8, "fourth-generation" cephalosporins (cefepime and cefpirome); group 9, carbapenems; group 10, monobactams; group 11, glycopeptides; group 12, antianaerobe agents and antibiotics with effects against atypical pathogens; group 13, aminoglycosides; group 14, antifungals; group 15, fluoroquinolones; group 16, colistin; and group 17, tigecycline.…”

Section: Patientsmentioning

confidence: 99%

Incidence of and Risk Factors for Community-Associated Methicillin-Resistant Staphylococcus aureus Acquired Infection or Colonization in Intensive-Care-Unit Patients

et al. 2010

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to clarify this issue. Surveillance cultures for MRSA were taken from nostril, sputum or throat, axillae, and the inguinal area in all enrolled patients upon admission to the ICU, every 3 days thereafter, and on the day of discharge from the ICU. For each MRSA isolate, we performed multilocus sequence typing, identified the type of staphylococcal cassette chromosome mec, detected the presence of the Panton-Valentine leukocidin gene, and conducted drug susceptibility tests. Among the 1,906 patients who were screened, 203 patients were carriers of MRSA before their admission to the ICU; 81 patients acquired MRSA during their stay in the ICU, including 31 who acquired CA-MRSA. The incidence rates of newly acquired MRSA and CA-MRSA during the ICU stay were 7.9 and 3.0 per 1,000 patient-days, respectively. Prior usage of antipseudomonal penicillins and antifungals and the presence of a nasogastric tube were found to be independent risk factors for acquiring CA-MRSA during the ICU stay when data for CA-MRSA carriers and patients without carriage of MRSA were compared (P ‫؍‬ 0.0035, 0.0330, and 0.0262, respectively

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“…In this study, severity of illness and presence of immunosuppression were the only two predictors of 30-day mortality. Of note, the study did not evaluate ampicillin-sulbactam susceptibilities, and thus, isolates could not be considered CASR (22).…”

mentioning

confidence: 99%

Epidemiology of Bloodstream Infections Caused by Acinetobacter baumannii and Impact of Drug Resistance to both Carbapenems and Ampicillin-Sulbactam on Clinical Outcomes

Chopra

Marchaim

Awali

et al. 2013

Antimicrob Agents Chemother

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In-hospital mortality rates for BSI caused by CASR A. baumannii were significantly higher than those for non-CASR A. baumannii-induced BSI (43% versus 20%; OR ‫؍‬ 3.0, 95% CI ‫؍‬ 1.60 to 5.23, P value < 0.001). However, after adjusting for potential confounders, the association between BSI caused by CASR A. baumannii and increased risk of in-hospital mortality was not significant (OR ‫؍‬ 1.15, 95% CI ‫؍‬ 0.51 to 2.63, P value ‫؍‬ 0.74). This study demonstrated that CASR A. baumannii had a distinct epidemiology compared to more susceptible A. baumannii strains; however, clinical outcomes were similar for the two groups. Admission with a rapidly fatal condition was an independent predictor for both CASR A. baumannii and in-hospital mortality.

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Prognosis of adult patients with bacteremia caused by extensively resistant Acinetobacter baumannii

Cited by 58 publications

References 37 publications

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated

Incidence of and Risk Factors for Community-Associated Methicillin-Resistant Staphylococcus aureus Acquired Infection or Colonization in Intensive-Care-Unit Patients

Epidemiology of Bloodstream Infections Caused by Acinetobacter baumannii and Impact of Drug Resistance to both Carbapenems and Ampicillin-Sulbactam on Clinical Outcomes

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