title: Bacteremia due to Acinetobacter baumannii: epidemiology, clinical findings, and prognostic features.
abstract: The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. During a 12-month study, there were 1.8 episodes of A. Baumannii bacteremia per 1,000 adults admitted to a hospital in Seville, Spain. Seventy-nine patients were included in the study. A. baumannii bacteremia occurred after a mean (+/- SD) hospitalization of 18 +/- 20 days. In all cases the infections were acquired nosocomially; 71% wee acquired in intensive care units. Ampicillin/ sulbactam was found to be the most active agent against A. baumannii. The common source of the bacteremia was the respiratory tract (32 cases [71%]). Twenty patients (25%) had septic shock, and 24 (30%) had disseminated intravascular coagulation (DIC). Treatment with imipenem or ampicillin/sulbactam was most effective (cure rates, 87.5% and 83%, respectively). The deaths of 27 patients (34%) were related to A baumannii bacteremia. The presence of DIC (odds ratio [OR] = 116.4; P < .0001) and inappropriate antimicrobial treatment (OR = 15.2; P < .01) were independently associated with mortality. We conclude that most A. baumannii isolates are multiresistant and that nosocomial A. baumannii bacteremia may cause severe clinical disease that is associated with a high mortality.
authors.affiliation: Microbiology Department, Hospital Universitario Virgen del Rocío, Seville, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Cisneros
authors.forename: M J
authors.initials: MJ
authors.lastname: Reyes
authors.forename: J
authors.initials: J
authors.lastname: Pachón
authors.forename: B
authors.initials: B
authors.lastname: Becerril
authors.forename: F J
authors.initials: FJ
authors.lastname: Caballero
authors.forename: J L
authors.initials: JL
authors.lastname: García-Garmendía
authors.forename: C
authors.initials: C
authors.lastname: Ortiz
authors.forename: A R
authors.initials: AR
authors.lastname: Cobacho
mesh_terms: D000150:Acinetobacter / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents