Risk factors for mortality in patients with Acinetobacter baumannii bloodstream infection with genotypic species identification.
OBJECTIVE
Acinetobacter baumannii is an increasingly common nosocomial infection with a high mortality rate. Identification of predictor factors of mortality from A. baumannii infection is important for the implementation of therapeutic management for patients with higher risk. However, many studies have reported data for Acinetobacter calcoaceticus-A. baumannii complex, which might lead to an uncertainty of results. In this study, we aimed to identify the predictive factors for mortality of patients infected with true A. baumannii that had been precisely identified by genotypic methodology.


METHODS
Sixty seven patients with documented A. baumannii bacteremia were identified from a medical center in northern Taiwan during the period between February 1998 and February 2001. The patients' medical records were retrospectively reviewed.


RESULTS
The risk factors associated with mortality in patients with A. baumannii bacteremia were underlying disease with malignancy, end-stage renal disease, and inappropriate antibiotic therapy. Laboratory variables, such as creatinine level, were also associated with poor prognosis by multivariate analysis.


CONCLUSIONS
Increased serum creatinine level, malignancy and inappropriate therapy within 3 days were related to increased mortality in patients with A. baumannii bloodstream infection. Physicians should be aware of patients with poor prognostic factors and initiate prompt strategies, including appropriate antimicrobial therapy, in order to reduce mortality.
Chiang
Dung-Hung
DH
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Wang
Chien-Chun
CC
Kuo
Han-Yueh
HY
Chen
Hsin-Pai
HP
Chen
Te-Li
TL
Wang
Fu-Der
FD
Cho
Wen-Long
WL
Liu
Cheng-Yi
CY
D000151:Acinetobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality*; D040981:Acinetobacter baumannii / Q000235:genetics / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric