[Acinetobacter baumannii bacteremia: clinical and prognostic features].
OBJECTIVE
The incidence, clinical features, and prognosis of bacteremia due to Acinetobacter baumannii were investigated.


METHODS
Prospective study of all episodes of A. baumanii bacteremia detected during the period of January 1995 to December 1998. A. baumannii was identified using recent standard methods.


RESULTS
A total of 133 episodes of bacteremia due to A. baumannii were studied, all of them nosocomial-acquired. The incidence-density diminished from 2.02 episodes per 10,000 patient-days to 0.40 episodes per 10,000 patient-days after the implementation of a control program. Most of the patients (70%) were, or had been, in the ICU when bacteremia occurred. Some 80% of patients had a chronic illness and 62% had a Hilf's severity score > 4. Among the strains identified, 74% were multidrug-resistant and 28% were imipenem-resistant. Attributable mortality was 25.6%. Multivariate analysis showed that inappropriate antibiotic treatment, septic shock, and high Hilf's severity score were associated with poorer prognosis.


CONCLUSIONS
A. baumannii bacteremia mainly affects severely ill patients who have undergone several invasive procedures, and who may have relevant associated morbidity and mortality. Among other variables, inappropriate antibiotic treatment was a risk factor for increased mortalilty.
Servicio de Medicina Interna, Sección de Enfermedades Infecciosas. Hospital Universitario Virgen Macarena. Sevilla. España.
Jesús
J
Rodríguez-Baño
Alvaro
A
Pascual
Juan
J
Gálvez
Miguel Angel
MA
Muniain
M José
MJ
Ríos
Luis
L
Martínez-Martínez
Ramón
R
Pérez-Cano
Evelio J
EJ
Perea
D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000382:microbiology / Q000401:mortality; D013030:Spain / Q000453:epidemiology
D000900:Anti-Bacterial Agents