Clinical features of pandrug-resistant Acinetobacter baumannii bacteremia at a university hospital in Taiwan.
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.
Kuo
Lu-Cheng
LC
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Yu
Chong-Jen
CJ
Lee
Li-Na
LN
Wang
Jiun-Ling
JL
Wang
Hao-Chien
HC
Hsueh
Po-Ren
PR
Yang
Pan-Chyr
PC
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
D000890:Anti-Infective Agents