Risk factors and outcomes of bloodstream infections with metallo-beta-lactamase-producing Acinetobacter.
The spread of Gram-negative bacilli with acquired metallo-beta-lactamase (MBL) threatens the successful treatment of major nosocomial infections. The objective of this study was to evaluate the differences in the clinical characteristics of bacteremia caused by MBL-producing Acinetobacter species and MBL non-producing isolates. Two retrospective case-control studies were conducted using data on patients with Acinetobacter bacteremia, who were admitted between January 2001 and December 2005 at a 1500-bed, tertiary-care teaching hospital. Case group 1 (n=27) included patients from whom imipenem-resistant Acinetobacter was isolated in blood culture, and case group 2 (n=7) consisted of those patients from group 1 who yielded MBL-producing isolates. The control group (n=41) included patients from whom carbapenem-susceptible Acinetobacter isolates were isolated in blood culture. Multivariate analysis revealed that the independent risk factors for imipenem-resistant Acinetobacter bacteremia were neutropenia and prolonged use of carbapenem. The independent risk factors for MBL-producing Acinetobacter bacteremia were neutropenia and prolonged use of cephalosporins. The results of this study suggest that a prolonged use of cephalosporins may be associated with MBL-producing Acinetobacter bacteremia.
Kim
Yeon-A
YA
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Choi
Jun Yong
JY
Kim
Chang Ki
CK
Kim
Chang Oh
CO
Kim
Myung Soo
MS
Choi
Suk Hoon
SH
Chin
Bum Sik
BS
Han
Sang Hoon
SH
Lee
Han Sung
HS
Choi
Hee Kyoung
HK
Jeoung
Su Jin
SJ
Song
Young Goo
YG
Yum
Jong Hwa
JH
Yong
Dongeun
D
Lee
Kyungwon
K
Kim
June Myung
JM
D000150:Acinetobacter / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D016022:Case-Control Studies; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001618:beta-Lactamases / Q000096:biosynthesis*
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D004269:DNA, Bacterial; D001618:beta-Lactamases