Clinical manifestations, antimicrobial therapy, and prognostic factors of monomicrobial Acinetobacter baumannii complex bacteremia.
OBJECTIVE
Bacteremia due to Acinetobacter baumannii complex (ABC), which composed of four genomic species (gen. sp.), is a serious and potentially fatal condition. The epidemiology and outcome of such infections due to individual gen. sp. remain undefined.


METHODS
A retrospective study of patients with monomicrobial ABC bacteremia over six years was conducted at a medical center to determine the association of gen. sp. with clinical outcome.


RESULTS
Included were 291 patients with monomicrobial ABC bacteremia. Of them, 222 (76.3%) patients had bacteremia caused by gen. sp. 2, i.e. A. baumannii. The presence of multidrug-resistant phenotype was the only independent predictor of Acinetobacter gen. sp. 2 bacteremia (adjusted odd ratio, 7.5; 95% confidence interval, 3.8-14.7; P < 0.001). Patients with Acinetobacter gen. sp. 2 bacteremia had a higher sepsis-related (P = 0.006) and 30 day (P = 0.028) mortality rates than the non-Acinetobacter gen. sp. 2 group. The fatal outcome was independently associated with high SPAS II scores (P = 0.002), rapidly fatal underlying diseases (P = 0.002), bacteremia caused by Acinetobacter gen. sp. 2 (P = 0.01), inappropriate definitive antimicrobial therapy (P < 0.001), and severe sepsis (P < 0.001).


CONCLUSIONS
Acinetobacter gen. sp. 2 bacteremia heralded a worse clinical outcome, and therefore the gen. sp. identification of ABC bacteremic isolates is justified.
Lee
Nan-Yao
NY
Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Chang
Tsung Chain
TC
Wu
Chi-Jung
CJ
Chang
Chia-Ming
CM
Lee
Hsin-Chun
HC
Chen
Po-Lin
PL
Lee
Ching-Chi
CC
Ko
Nai-Ying
NY
Ko
Wen-Chien
WC
D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents