title: Clinical features of pandrug-resistant Acinetobacter baumannii bacteremia at a university hospital in Taiwan.
abstract: OBJECTIVE
  The number of infections caused by Acinetobacter baumannii has increased in recent years and the emergence of pandrug-resistant A. baumannii (PDRAB) has been observed in Taiwan. The aim of this study was to evaluate the clinical features and outcomes of patients with bacteremia due to PDRAB.
  
  
  METHODS
  From January 1999 to April 2002, 30 patients with PDRAB bacteremia were treated. We analyzed the clinical characteristics of these patients, including gender, underlying diseases, clinical manifestations, antibiotic treatment, and outcome.
  
  
  RESULTS
  Bacteremia developed an average of 33 days after hospitalization and was hospital acquired in all cases. The source of bacteremia was identified in 19 patients (63.3%) and was most commonly from the respiratory tract. The overall mortality was 60% (18 patients). Among these, the cause of death was directly related to PDRAB bacteremia in 12. Underlying heart disease, shock, resuscitation, acute respiratory distress syndrome, mechanical ventilation, and multiple organ dysfunction score (MODS) were significant predictors of mortality after the development of PDRAB bacteremia. No specific antimicrobial therapy appeared to be effective.
  
  
  CONCLUSIONS
  Clinical outcomes of patients with PDRAB bacteremia were related to the medical conditions of the patients at the time of development of bacteremia and could be predicted by the MODS. The only way to limit the spread is through strict preventive measures for nosocomial infection and antibiotic control.
authors: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Lu-Cheng
authors: LC
authors: Kuo
authors: Chong-Jen
authors: CJ
authors: Yu
authors: Li-Na
authors: LN
authors: Lee
authors: Jiun-Ling
authors: JL
authors: Wang
authors: Hao-Chien
authors: HC
authors: Wang
authors: Po-Ren
authors: PR
authors: Hsueh
authors: Pan-Chyr
authors: PC
authors: Yang
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000401:mortality; D040981:Acinetobacter baumannii; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D013624:Taiwan
chemical_list: D000890:Anti-Infective Agents