Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit.
This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In the multivariate Cox regression model, septic shock [adjusted hazard ratio (aHR) 5·01, 95% confidence interval (CI) 2·32-10·01] and APACHE II score at onset of infection (aHR 1·11, 95% CI 1·04-1·18) were significantly associated with 30-day mortality. Administration of appropriate therapy was a protective factor, but it was not statistically significant (aHR 0·48, 95% CI 0·21-1·12). A sample of isolates tested (n=27) carried the blaOXA-23 gene. Severity of baseline condition and severity of infection presentation were major risk factors for mortality during the outbreak. Patients who received appropriate therapy tended to have lower mortality rates, although therapy was started late and dosage was suboptimal in most cases.
Prates
C G
CG
Medical Sciences Postgraduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Martins
A F
AF
Superti
S V
SV
Lopes
F S
FS
Ramos
F
F
Cantarelli
V V
VV
Zavascki
A P
AP
D018806:APACHE; D000151:Acinetobacter Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015780:Carbapenems / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012307:Risk Factors; D012772:Shock, Septic / Q000401:mortality / Q000473:pathology; D018440:beta-Lactam Resistance
D000900:Anti-Bacterial Agents; D015780:Carbapenems