title: Acinetobacter baumannii bacteraemia in patients with haematological malignancy: a multicentre retrospective study from the Infection Working Party of Jiangsu Society of Hematology.
abstract: Acinetobacter baumannii (Ab) bacteraemia in patients with haematological malignancies is fatal but rarely reported. We explored the clinical characteristics, drug resistances and prognostic factors in these patients. This multicentre, retrospective study was conducted at the department of haematology wards of 18 tertiary hospitals in China from January 2014 to June 2015. The total clinical isolates from every source were collected from patients with haematological malignancy. Haematological malignancy patients diagnosed with Ab bacteraemia were analysed. During the study period, 40 patients with Ab bacteraemia were identified, accounting for 2.9% (40/1358) of bacteraemia cases, of which 25 (62.5%) had acute leukaemia (AL) and 27 (67.5%) had neutropaenia. Compared with non-neutropaenic patients, neutropaenic patients showed higher Acute Physiology and Chronic Health Evaluation (APACHE) scores and 30-day mortality rates (p < 0.05). The in vitro antibiotic susceptibility of Ab to colistin was highest, at 100%, followed by that of tigecycline (91.30%) and amikacin (75.86%). Compared with the patients who had carbapenem-susceptible Ab infections, patients infected with carbapenem-resistant Ab (CRAB) had significantly longer hospital stays and were more likely to have had exposure to carbapenem before bacteraemia (p < 0.05). The 30-day mortality rate was 32.5%. CRAB, neutropaenia, higher APACHE score, Pitt bacteraemia score and inappropriate initial antimicrobial therapy were significantly associated with 30-day mortality. Multivariable analysis showed that APACHE score and CRAB were independent predictors of 30-day mortality. Haematologic patients with AL and febrile neutropaenia were at high risk of Ab bacteraemia. More attention should be paid to CRAB, which is an independent risk factor for mortality in haematological malignancy patients with Ab bacteraemia.
authors.affiliation: Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China.|Department of Hematology, No. 454 Hospital of the PLA, Nanjing, 210000, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Hematology, Xuzhou First People's Hospital, Xuzhou, Jiangsu Province, People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, The First Affiliated Hospital of Suzhou University, Suzhou, Jiangsu Province, People's Republic of China.
authors.forename: A
authors.initials: A
authors.lastname: Sun
authors.affiliation: Department of Hematology, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, The First Affiliated Hospital of Suzhou University, Suzhou, Jiangsu Province, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Hematology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu Province, People's Republic of China.
authors.forename: W
authors.initials: W
authors.lastname: Sang
authors.affiliation: Department of Hematology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Hematology, Zhongda Hospital affiliated to Southeast University, Nanjing, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China.
authors.forename: M
authors.initials: M
authors.lastname: Zhou
authors.affiliation: Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China.
authors.forename: B
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China. ouyangy211@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Ouyang
mesh_terms: D018806:APACHE; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D002681:China; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents