title: Risk and Prognostic Factors for Multidrug-Resistant Acinetobacter Baumannii Complex Bacteremia: A Retrospective Study in a Tertiary Hospital of West China.
abstract: BACKGROUND
  The increasing prevalence and mortality of multidrug-resistant (MDR) Acinetobacter baumannii complex-associated infections, especially bacteremia, in health care settings poses a great threat to public health. We proceeded to investigate the risk and prognostic factors for MDR A. baumannii complex bacteremia in mainland China.
  
  
  METHODS
  This retrospective study was conducted at West China Hospital from January 2009 to December 2013. Using a computer-assisted microbiology laboratory database, patients with MDR A. baumannii complex bacteremia were included as the case group, while those infected with non-MDR A. baumannii complex were selected as the control group. The clinical data were collected and analyzed.
  
  
  RESULTS
  There were 241 non-duplicated A. baumannii complex blood isolates identified in our research, with the overall rate of multidrug resistance reaching 75.52% over the past five years. Using multivariate logistic analysis, being in the intensive care unit (ICU) (adjusted odds ratio [aOR], 5.84; 95% confidence interval [CI], 1.67-20.44), increased Pittsburgh bacteremia score (aOR, 6.55; 95% CI, 1.27-33.70) and use of carbapenem (aOR, 8.90; 95% CI, 1.71-46.30) were independent risk factors for MDR acquisition among patients with A. baumannii complex bacteremia. Older age (aOR, 1.02; 95% CI, 1.00-1.04), being post-transplantation (aOR, 5.21; 95% CI, 1.13-24.04), having a higher Pittsburgh bacteremia score (aOR, 2.19; 95% CI, 1.08-4.47) and having a lower level of albumin (aOR, 0.93; 95% CI, 0.88-0.99) were identified as independent risk factors for 30-day mortality in patients with MDR A. baumannii complex bacteremia.
  
  
  CONCLUSIONS
  In conclusion, our research revealed the risk factors associated with acquisition of and mortality from MDR A. baumannii complex bacteremia, which may be used to prioritize infection control practices and prognostic evaluations.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
authors.forename: Wenzhang
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xinmiao
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Weijing
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Taiqing
authors.initials: T
authors.lastname: Zhong
authors.affiliation: Division of Oral Biology, Tufts University School of Dental Medicine, Boston, Massachusetts, United States of America.
authors.forename: Yin
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Chuanmin
authors.initials: C
authors.lastname: Tao
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xie
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents