[Acinetobacter baumannii bacteremia: clinical and prognostic features]

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Acinetobacter baumannii is a significant cause of nosocomial infections.
• Bacteremia due to A. baumannii presents challenges in treatment and patient outcomes.

Purpose of the Study:

• To investigate the incidence, clinical characteristics, and prognosis of Acinetobacter baumannii bacteremia.
• To evaluate the impact of a control program on A. baumannii bacteremia incidence.

Main Methods:

• Prospective study of A. baumannii bacteremia episodes from January 1995 to December 1998.
• Standard microbiological methods for A. baumannii identification.
• Multivariate analysis to identify factors associated with prognosis.

Main Results:

• 133 episodes of nosocomial A. baumannii bacteremia were analyzed.
• Incidence decreased significantly after implementing a control program.
• Most patients were in the ICU, had chronic illnesses, and high severity scores.
• High rates of multidrug-resistant (74%) and imipenem-resistant (28%) strains were observed.
• Attributable mortality was 25.6%, with inappropriate antibiotic treatment, septic shock, and high severity scores linked to poorer outcomes.

Conclusions:

• A. baumannii bacteremia predominantly affects severely ill patients with comorbidities and invasive procedures.
• Inappropriate antibiotic therapy is a significant risk factor for increased mortality.
• Effective control programs and appropriate treatment are crucial for managing A. baumannii bacteremia.