Risk factors for pneumonia caused by antimicrobial drug-resistant or drug-sensitive Acinetobacter baumannii infections

Abstract

Acinetobacter baumannii (AB) is one of the major types of infection in hospitalized patients. The development of AB resistance is becoming a global clinical challenge. To assist in the clinical management of AB-induced pneumonia, we designed the present retrospective observational study to investigate the risk factors for antimicrobial drug-resistant/-sensitive AB infections. A total of 214 individuals were reviewed, in which 100 and 55 pneumonia patients were infected with drug-resistant and drug-sensitive AB, respectively. Fifty-nine pneumonia patients without AB infection served as a control group. Age, sex, duration of hospital stay, prior surgery history, the presence of coinfection and companion diseases, routine blood test results, and immunogenicity were recorded. Logistic regression was performed to identify risk factors of AB infections. Multivariate analysis revealed that long duration of hospital stay (odds ratio = 1.091 [95% CI: 1.010–1.178], P = .027) and the absence of coinfection (odds ratio = 0.507 [95% CI: 0.265–0.970], P = .040) were independent risk factors for AB infections. Same pattern of risk factors was identified for the drug-sensitive group (long duration of hospital stay: odds ratio = 1.119 [95% CI: 1.016–1.232], P = .022; absence of coinfection: odds ratio = 0.328 [95% CI: 0.135–0.797], P = .014), while high blood urea nitrogen (odds ratio: 1.382 [95% CI: 1.042–1.833], P = .025) was the only significant risk factor for drug-resistant AB infection. Long duration of hospital stay and the absence of coinfection might predict AB infections in hospitalized patients. Antimicrobial drug-resistant and drug-sensitive AB infections possess different risk factor profiles. A poor kidney function may be predictive of drug-resistant AB infection. Further prospective studies are required to validate our findings.

Derivation and Validation of a Predictive Scoring Model of Infections Due to Acinetobacter baumannii in Patients with Hospital Acquired Pneumonia by Gram-Negative Bacilli

“… 4 Although the risk factors for ABA infection (eg, invasive mechanical ventilation, critical condition, prior culture result of ABA, etc.) are generally recognized, 17 , 18 there is currently no universally accepted and easily used prediction tool to evaluate the possibility of ABA-HAP in a single patient. Our model can overcome the limitations of long culture time, low positive rate of bacterial culture and the probability of ABA-HAP unquantified.…”

Facing Resistant Bacteria with Plant Essential Oils: Reviewing the Oregano Case

“…Some species of this genus can be found in different environments; however, A. baumannii is mainly associated with hospital settings [ 28 , 29 ]. One million cases of infection are attributed to this species each year [ 30 ], with mortality rates ranging from 23 to 68% for HAI and up to 64% for community-acquired infections.…”