title: Risk factors and outcomes of bloodstream infections with metallo-beta-lactamase-producing Acinetobacter.
abstract: 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.
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yeon-A
authors.initials: YA
authors.lastname: Kim
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Chang Ki
authors.initials: CK
authors.lastname: Kim
authors.forename: Chang Oh
authors.initials: CO
authors.lastname: Kim
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Suk Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Bum Sik
authors.initials: BS
authors.lastname: Chin
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.forename: Han Sung
authors.initials: HS
authors.lastname: Lee
authors.forename: Hee Kyoung
authors.initials: HK
authors.lastname: Choi
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jeoung
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.forename: Jong Hwa
authors.initials: JH
authors.lastname: Yum
authors.forename: Dongeun
authors.initials: D
authors.lastname: Yong
authors.forename: Kyungwon
authors.initials: K
authors.lastname: Lee
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D004269:DNA, Bacterial; D001618:beta-Lactamases