Risk factors associated with the mortality of Acinetobacter baumannii

Abstract

Background: Acinetobacter baumannii (AB) was declared an antibiotic-resistant “Priority 1 pathogen” by WHO. We sought to investigate the predisposing risk factors to this pathogen. Methods: In a retrospective study, adults who were admitted to Sohar hospital during 2016-2017 and had a positive laboratory-confirmed culture of AB were studied.We classified patients into 2 groups based on 30-day, all-cause mortality and compared the characteristics. Exploratory classification and regression tree (CART) analysis was performed to explore risk factors for mortality to include to a logistic regression model. Results: A total of 321 patients were included, age was (Mean±SD) 57.42±20.22, male gender was 180(56.07%), mortality was 140(44%). Survivors vs deceased had; length of stay 38.25±88.74 vs 51.31±79.19 (p=0.002),multi-drug resistantisolates 134(51.34%) vs 127(48.66%) p=<0.001, critical care admission 35(38.04%) vs 57(61.96%) p=<0.001, comorbidities 114(47.50%) vs 126(52.50%) p=<0.001 and history of invasive procedures 82(59.85%) vs 55(40.15%) p=0.27. Logistic regression revealed that the odds of dying increase by a factor of 1.044 for every additional year of age, 1.844 times higher for male compared to female, 4.412 times higher for patients admitted into critical care units compared to general wards, 3.138 times higher for patients admitted with a diagnosis of infection, 2.356 times higher for patients with hospital-acquired AB infection compared to community-acquired. Conclusion: Both modifiable and non-modifiable risk factors are associated with mortality and overall health status may contribute to infection outcome. Stabilization of comorbidities and effective antimicrobial treatment could be the mainstay of successful prevention.

Antibiotic resistance pattern of Acinetobacter baumannii strains: A retrospective study from Oman

“…There was no gender-based difference in the frequency of isolation of A. baumannii in the current study, which is in contrast with the findings of previous studies showing a higher frequency of isolation among males. [ 14 15 ] Medical and surgical interventions such as urinary and central venous catheterization, mechanical ventilation, prior surgery, etc., are potential risk factors associated with A. baumannii infection. [ 16 17 ] In the current study, the majority of the patients had been exposed to one or more of these interventions either in the wards or ICUs.…”